Fully covered metal biliary stents: A review of the literature

Table 1 Strengths and disadvantages of plastic stents and self-expandable metal stents

	Strengths	Disadvantages
Plastic stents	Easy placement, removal, and exchange; Cost-effective for use < 4 mo; Variety of shapes and sizes	Tendency for stent occlusion after several months
Uncovered self-expandable metal stents (USEMS)	Long stent patency due to large luminal diameter; Stent malposition is rare	Cost-effective for use > 4 mo; High risk for tissue ingrowth or tumor overgrowth; Risk for duodenal wall erosion; Biliary leakage possible; Difficult to reposition or remove
Partially covered self-expandable metal stents (PCSEMS)	Long stent patency due to large luminal diameter; Biliary leakage is rare	Cost-effective for use > 4 mo; Intermediate risk for tissue ingrowth or tumor overgrowth; Risk for duodenal wall erosion; Difficult to reposition or remove; Side branch obstruction possible
Fully covered self-expandable metal stents (FCSEMS)	Long stent patency due to large luminal diameter, covering inhibits tissue/tumor in-growth through mesh; No biliary leakage	Cost-effective for use > 4 mo; Risk for duodenal wall erosion; Difficult to reposition or remove; High risk of stent migration; Side branch obstruction possible