3:45 PM Abstract No. 165 Biodegradable biliary stents for benign biliary anastomotic strictures: preliminary results and short-term outcomes

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Assess the effectiveness of Biodegradable biliary stents in the management of benign anastomotic biliary strictures refractory to cholangioplasty and biliary drainage. This is a retrospective study of consecutive patients who underwent biodegradable stent placement for benign anastomotic biliary strictures since July 2016. Eight patients (6 males) were included with mean age of 53 years (23-72 years). Six patients had liver transplant (4 choledochocholedochal anastomosis, 2 hepaticojejunal anastomosis). Two patients had primary sclerosing cholangitis with hepaticojejunal anastomosis. The mean time since surgery was 4.4 years. All patients had anastomtic strictures managed by percutaneous biliary drainage prior to stent placement. Six patients had previous (1-4) sessions of biliary dilatation. Two patients preferred stent placement to avoid long-term tube dependence. Eight patients received a 10-mm x 40-mm Ella biodegradable stent at the anastomosis. One patient died 2 month later due to progressive liver cirrhosis. Five patients required no reintervention at mean follow-up time of 232 days (96-322 days). Two liver transplant patients required reintervention. One patient with hepaticojejunal anastomosis had biodegradable stent re-insertion after 214 days and ultimately had recurrence of strictures after 84 days after the second intervention. One transplant patient with choledochocholedocal anastomosis presented after 143 days with recurrent obstructive jaundice due to sludge, which was managed by endoscopic plastic stent placement. There was one major procedure related complication (cholangitis and sepsis) and one minor complication (limited septicemia). No procedure related mortality. The two patients who required reintervention had partial or complete stent dissolution at the time of recurrence. Biodegradable biliary stent may offer a safe and effective option to avoid tube dependence and prolong time-to-reintervention in patients with benign anastomotic biliary strictures.