Temporary FC-SEMS for type II ERCP-related perforations: a case series from two referral centers and review of the literature

Abstract

Background and aim: Some case reports have shown that fully covered self-expandable metal stents (FC-SEMS) are effective in cases of Stapfer Type II perforation as rescue treatment. The aim of the study was to assess the efficacy and safety of temporary placement of FC-SEMS as primary treatment for Type II perforations and review the literature regarding the use of FC-SEMS in this setting.Patients and method: Retrospective analysis of consecutive patients with Type II perforation treated with immediate placement of FC-SEMS. Primary outcomes were need for surgery and mortality rate. Secondary outcomes were complications, technical and clinical success, time to post-operative feeding, length of the hospitalization and time to stent removal.Results: Overall, 18 consecutive patients were enrolled (median age 71.5). All patients were treated with FC-SEMS (6–10 mm, 4–8 cm long). In all patients, there were no need for surgery, and no patient died. Technical and clinical success were achieved both in 100% of cases. The median time to stent removal was 43 (2–105) days. The median hospital stay was of 10 (4–21) days. Median time to post-operative feeding was 4 days (2–15).Conclusion: FC-SEMS placement could be a safe and effective treatment in Type II perforations and represent a valuable development and innovation of conservative treatment.