Benign Biliary Strictures, Leaks, and Stones: Clinical Application of Retrievable Fully Covered Self-Expandable Metallic Biliary Stent with an Alternative Retrieval String Fixation Method.

PURPOSE: To evaluate the clinical application and outcomes of a percutaneously placed, retrievable, fully covered self-expandable metallic stent with retrieval string with those of an alternative retrieval string fixation technique for the management of benign biliary conditions.

MATERIALS AND

METHODS

This single-center, retrospective study included 87 patients who underwent percutaneous placement of retrievable fully covered self-expandable metallic stent with retrieval string between March 2020 and February 2025. Patients were categorized according to indication: anastomotic stricture (n = 30), bile leak (n = 41), and biliary stones (n = 16). The primary outcomes were technical and clinical success rates, with secondary outcomes including complication rates and long-term patency.

RESULTS

Technical success was achieved in 98% of procedures. Clinical success rates were 97% for anastomotic strictures (6-month follow-up), 91% for bile leaks, and 94% for biliary stones. Mean stent indwelling times were 3.0 ± 0.8, 1.9 ± 0.7, and 0.7 ± 0.3 months, respectively. The estimated mean recurrence-free duration for anastomotic strictures was 41.7 months, with a 36-month patency rate of 67%. Stent migration occurred in 3.4% (3/87) of patients, while 1 retrieval string breakage and 3 cases of cholangitis were recorded.

CONCLUSIONS

In this single-center observational cohort, percutaneous implantation of a retrievable fully covered self-expandable metallic stent with retrieval string using an alternative fixation technique appears to be a safe and effective approach for the management of benign biliary conditions. In the study cohort, this technique was associated with favorable long-term patency in anastomotic strictures, favorable outcomes in bile leaks and stones, and a low rate of stent migration.