Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2021; 27(38): 6357-6373
Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6357
Fully covered metal biliary stents: A review of the literature
Robert Lam, Thiruvengadam Muniraj
Robert Lam, Thiruvengadam Muniraj, Department of Medicine, Yale University School of Medicine, New Haven, CT 06520, United States
Author contributions: Lam R and Muniraj T equally contributed to the work; All authors have read and approved the final manuscript.
Conflict-of-interest statement: None of the authors have any conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Thiruvengadam Muniraj, FRCP, MD, PhD, Assistant Professor, Department of Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, United States.
Received: March 30, 2021
Peer-review started: March 30, 2021
First decision: June 23, 2021
Revised: July 9, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: October 14, 2021

Fully covered self-expandable metal stents (FCSEMS) represent the latest advancement of metal biliary stents used to endoscopically treat a variety of obstructive biliary pathology. A large stent diameter and synthetic covering over the tubular mesh prolong stent patency and reduce risk for tissue hyperplasia and tumor ingrowth. Additionally, FCSEMS can be easily removed. All these features address issues faced by plastic and uncovered metal stents. The purpose of this paper is to comprehensively review the application of FCSEMS in benign and malignant biliary strictures, biliary leak, and post-sphincterotomy bleeding.

Keywords: Fully covered self-expandable metal stents, Plastic stents, Endoscopy, Chronic pancreatitis, Biliary stricture, Biliary leak, Stent migration

Core Tip: Fully covered self-expandable metal stents (FCSEMS) are composed of a metal alloy tubular mesh with a synthetic covering to minimize tumor ingrowth. They have a broad range of biliary endoscopic applications, including the treatment of strictures, biliary leak, and post-sphincterotomy bleeding. Novel anchoring designs have been effective at addressing the common problem of stent migration with FCSEMS.