Inserción de prótesis metálicas autoexpandibles totalmente recubiertas en patología biliar benigna

espanolIntroduccion: las enfermedades biliares benignas se han tratado, tradicionalmente, mediante la colocacion de protesis plasticas. Sin embargo, en la actualidad, las protesis metalicas autoexpandibles totalmente recubiertas estan ganando aceptacion para el tratamiento de dichas patologias. Objetivo: evaluar la eficacia y las complicaciones de la insercion endoscopica temporal de protesis metalicas totalmente recubiertas para el tratamiento de patologias biliares benignas. Materiales y metodos: estudio retrospectivo y observacional realizado a partir de una base de datos prospectiva en un centro de tercer nivel entre marzo de 2012 y mayo de 2016. Se incluyeron pacientes a los que se les coloco una protesis metalica totalmente recubierta por patologia benigna de la via biliar. Se documentaron las indicaciones, las tasas de resolucion, las de exito tecnico y los eventos adversos. Resultados: se incluyeron 31 pacientes a los que se insertaron 34 protesis. Las indicaciones fueron las siguientes: 8 (25%) estenosis biliares poscolecistectomia, 11 (31%) coledocolitiasis de gran tamano o multiple, 3 (8,3%) fistulas biliares, 2 (6%) estenosis postrasplante hepatico, 3 (8,3%) estenosis papilares, 2 (6%) perforaciones y 2 (6%) sangrados. La tasa de exito global de resolucion de la patologica fue del 88%: 87,5% (7/8) en estenosis poscolecistectomia, 73% (8/11) en litiasis gigante, y 100% en el resto de las indicaciones. Se retiraron mediante endoscopia 33 de las 34 tras un promedio de 133 dias (rango 10-180 dias). No se registraron complicaciones. Conclusion: las protesis metalicas autoexpandibles totalmente recubiertas son una alternativa efectiva y segura en la resolucion de patologias biliares benignas. EnglishIntroduction: Benign biliary diseases are traditionally treated using plastic stents. However, fully covered self-expanding metal stents are currently gaining acceptance for the treatment of these pathologies. Objective: To assess the effectiveness and complications associated with the placement of temporary endoscopic fully covered self-expanding metal stents for the treatment of benign biliary diseases. Materials and methods: This was a retrospective and observational study using a prospective database from a tertiary care center from March 2012 to May 2016. Some patients that had a fully covered metal stent due to a benign biliary disease were also included. The indications, resolution, technical success rates and adverse events were documented. Results: 31 patients were included with a total of 34 stents inserted. The indications were as follows: 8 (25%) post cholecystectomy biliary stenoses, 11 (31%) large or multiple choledocholithiasis, 3 (8.3%) biliary fistulas, 2 (6%) post-liver transplant stenoses, 2 (8.3%) papillary stenoses, 2 (6%) perforations and 2 (6%) bleeds. The global resolution success rate of the stents for all pathologies was 88%, this included 87.5% (7/8) in post cholecystectomy stenoses, 73% (8/11) in large choledocholithiasis and 100% for the remaining indications. Thirty-three of 34 stents were removed after an average of 133 days (ranging from 10 to 180 days). No complications were registered. Conclusion: Fully covered self-expanding metal stents are an effective and reliable alternative for the resolution of benign biliary diseases.