Copyright
©The Author(s) 2021.
World J Gastroenterol. Oct 14, 2021; 27(38): 6357-6373
Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6357
Published online Oct 14, 2021. doi: 10.3748/wjg.v27.i38.6357
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 |
Table 2 Etiology of benign biliary strictures
Extrinsic | Intrinsic |
Chronic pancreatitis | Post-operative (i.e., post-liver transplantation and post-cholecystectomy) |
Pancreatic fluid collection | Primary sclerosing cholangitis |
Cholecystitis | IgG Cholangiopathy |
Table 3 Comparison of study outcomes of plastic stents and fully covered self-expandable metal stents for treatment of post-operative benign biliary strictures
Ref. | Methods | Patients | Stent placement | Followup time(mo) | Clinical success1 (%) | Recurrence (%) |
Bergman et al[42] | Retrospective, single center | 57 | Two 10F plastic stents | 24 | 77 | 20 |
Costamagna et al[41] | Retrospective, single center | 154 | Multiple plastic stents | 108 | 96.7 | 12 |
Chaput et al[44] | Retrospective, single center | 92 | FCSEMS | 12 | 84.9 | 21.9 |
Tringali et al[47] | Prospective, mult-center | 187 | FCSEMS | 60 | 83.3 | 15.4 |
Table 4 Comparison of study outcomes usng fully covered self-expanding metal stents for treatment of biliary leak
Ref. | Methods | Patients | Type, duration of stent placement (mo) | Follow-up time (mo) | Clinical success rate1 (%) |
Martins et al[110] | Restrospective, single center | 31 | PCSEMS (3), FCSEMS with fins (3.3), FCSEMS with flare ends (3) | PCSEMS (44), FCSEMS with fins (27), FCSEMS with flare ends (6.6) | PCSEMS (100), FCSEMS with fins (77.8), FCSEMS with flare ends (70) |
Lalezari et al[111] | Retrospective, single center | 5 | FCSEMS with fins (3) | 26 | 100 |
Kahaleh et al[112] | Retrospective single, center | 16 | FCSEMS (3) | 9 | 94 |
- Citation: Lam R, Muniraj T. Fully covered metal biliary stents: A review of the literature. World J Gastroenterol 2021; 27(38): 6357-6373
- URL: https://www.wjgnet.com/1007-9327/full/v27/i38/6357.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i38.6357