Safety and Efficacy of Endoscopically Secured Fully Covered Self-Expandable Metallic Stents (FCSEMS) for Post-Bariatric Complex Stenosis

Overview

Journal Obes Surg

Date 2019 Jun 30

PMID 31254212

Citations 6

Authors

Lea Fayad

Cem Simsek

Roberto Oleas

Yervant Ichkhanian

Georges E Fayad

Saowanee Ngamreungphong

Michael Schweitzer

Andreas Oberbach

Anthony N Kalloo

Mouen A Khashab

Vivek Kumbhari

Affiliations

Soon will be listed here.

Abstract

Background: The use of fully covered self-expandable metallic stents (FCSEMS) has opened the door to treat stenosis in the post-bariatric stomach. We hypothesized that endoscopically securing a FCSEMS would be technically feasible, effective, and safe for > 30-day dwell time.

Objectives: To assess the technical feasibility, clinical efficacy, and safety of endoscopically secured FCSEMS in the stomach for > 30 days.

Methods: A retrospective review (September 2016 to April 2018) of consecutive patients who underwent FCSEMS suturing in the stomach at a single academic institution was reviewed. Technical success, stent dwell time, symptoms, and adverse events were recorded.

Results: Fifteen patients (median age of 49 (31-70)) were included. Stents were inserted for gastrojejunal (GJ) stricture or gastric stenosis in 9/15 and 6/15 of patients, respectively. All procedures were technically successful (100%). Immediate and short-term clinical success (prior to stent removal) was 100% in patients who did not have stent migration. Stent migration was seen in 3 cases (20%) after a median dwell time of 211 days. However, 2/3 (66.6%) had not attended their scheduled removal. Recurrence of symptoms after stent removal was seen in 53.3% of patients with 40% undergoing repeat stenting. Median stent dwell was 117 (30-342) days. Sixty percent and 33% of patients had stent dwell of at least 90 and 180 days, respectively.

Conclusions: A FCSEMS, if secured, may be safe and effective for even > 90-day dwell time in the post-bariatric stomach and may result in long-term clinical success for GJ stricture after stent removal.

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