Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 25, 2016; 8(2): 77-85
Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.77
Drug eluting biliary stents to decrease stent failure rates: A review of the literature
Joseph Shatzel, Jisoo Kim, Kartik Sampath, Sharjeel Syed, Jennifer Saad, Zilla H Hussain, Kabir Mody, J Marc Pipas, Stuart Gordon, Timothy Gardner, Richard I Rothstein
Joseph Shatzel, J Marc Pipas, Section of Hematology-Oncology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, United States
Jisoo Kim, Sharjeel Syed, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, United States
Kartik Sampath, Zilla H Hussain, Stuart Gordon, Timothy Gardner, Richard I Rothstein, Section of Gastroenterology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, United States
Jennifer Saad, Section of Internal Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, United States
Kabir Mody, Mayo Clinic Cancer Center, Section of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, FL 32224, United States
Author contributions: All authors contributed equally to the work, researched the topic and wrote the review.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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:
Correspondence to: Joseph Shatzel, MD, Section of Hematology-Oncology, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, United States.
Telephone: +1-603-6508380 Fax: +1-603-6506122
Received: April 3, 2015
Peer-review started: April 4, 2015
First decision: June 2, 2015
Revised: August 11, 2015
Accepted: October 17, 2015
Article in press: October 28, 2015
Published online: January 25, 2016

Biliary stenting is clinically effective in relieving both malignant and non-malignant obstructions. However, there are high failure rates associated with tumor ingrowth and epithelial overgrowth as well as internally from biofilm development and subsequent clogging. Within the last decade, the use of prophylactic drug eluting stents as a means to reduce stent failure has been investigated. In this review we provide an overview of the current research on drug eluting biliary stents. While there is limited human trial data regarding the clinical benefit of drug eluting biliary stents in preventing stent obstruction, recent research suggests promise regarding their safety and potential efficacy.

Keywords: Bile ducts, Cholangiocarcinoma, Endoscopy, Pancreas

Core tip: Despite the short life expectancies of patients with biliary tract cancers, biliary stenting suffers from high stent re-obstruction rates, provoking unneeded costs, morbidity and mortality. Drug eluting stents offer the possibility of decreasing stent failure rates from both biliary stent clogging, and external obstruction from tumor and epithelial ingrowth. In this inclusive review we outline the current body of experimental literature on drug eluting stents including bench, animal and human trials, and discuss possible targets for future research.