Kaffes Stent in the Management of Post-surgical Biliary Strictures
Kaffes Stent in the Management of Post-surgical Biliary Strictures
Post-surgical biliary strictures are common especially after cholecystectomy. Standard
 treatment involves the performance of multiple procedures over a 1 year period at least using
 several plastic stents to achieve permanent dilatation of these strictures.

 Metallic stents have the theoretical benefit of absence of need of multiple sessions.

 These strictures however are frequently very close to the hilum and thus previously
 considered a contraindication for insertion of metallic stents for the fear of occlusion of
 the contralateral ducts. Metallic stent migration is also a frequent problem.

 The use of a metallic stent that is short and completely intraductal, in theory, should
 reduce the risk of stent migration.

 This is a randomized controlled trial comparing the efficacy and safety of a short metallic
 intraductal stent to the conventional treatment which is multiple plastic stents. In cases
 with a stricture reaching or close to the hilum a technique is used to avoid obstruction of
 the contralateral ducts which is insertion of a 7 French plastic stent alongside the metallic
 stent.
Inclusion Criteria:

 -  Confirmed benign postsurgical biliary stricture by presence of all 3 of the following:

 Ultrasound imaging or Magnetic resonance cholangiopancreatography (MRCP) showing biliary
 dilatation, Raised bilirubin and or alkaline phosphatase, History of biliary tree surgery
 within the previous year

 -  Naïve to endoscopic therapy

 -  Age > 18 years

 Exclusion Criteria:

 -  Coagulopathy

 -  Inability of patient to adhere to regular follow-up

 -  Living-donor liver transplant patients