Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6357
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.
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.