Future developments in biliary stenting

Abstract

Biliary stenting has evolved dramatically over the past 30 years. Advancements in stent design have led to prolonged patency and improved efficacy. However, biliary stenting is still affected by occlusion, migration, anatomical difficulties, and the need for repeat procedures. Multiple novel plastic biliary stent designs have recently been introduced with the primary goals of reduced migration and improved ease of placement. Self-expandable bioabsorbable stents are currently being investigated in animal models. Although not US Food and Drug Administration approved for benign disease, fully covered self-expandable metal stents are increasingly being used in a variety of benign biliary conditions. In malignant disease, developments are being made to improve ease of placement and stent patency for both hilar and distal biliary strictures. The purpose of this review is to describe recent developments and future directions of biliary stenting.

An Update to Hepatobiliary Stents

“…1 Dua et al did a prospective randomized trial using the 10F antireflux plastic biliary stent (Tannenbaum type). Patency average was 145 days for the reflux stents and 101 days for control group plastic stents, and this difference was not statistically significant.…”

“…1 Benign biliary strictures are significant because they can cause jaundice, hepatocellular dysfunction, biliary cirrhosis, pain, pruritus, and cholangitis. 3 Hepatobiliary malignancy causes obstruction in 70-90% of patients, causing similar complications.…”

“…3 Hepatobiliary malignancy causes obstruction in 70-90% of patients, causing similar complications. [1][2][3] Prior to the use of stents, the primary treatment for biliary obstruction was surgery, such as cholecystojejunostomy or choledochojejunostomy. 4 The endoscopic placement of biliary stents was first introduced in the early 1980s.…”

An Update to Hepatobiliary Stents

“…Biliary obstruction can occur from both malignant and benign conditions, including pancreatic cancer, cholangiocarcinoma, metastatic disease, chronic pancreatitis, choledocolithaisis, and postoperative strictures. 1 Benign biliary strictures are significant because they can cause jaundice, hepatocellular dysfunction, biliary cirrhosis, pain, pruritus, and cholangitis. 3 Hepatobiliary malignancy causes obstruction in 70–90% of patients, causing similar complications.…”

“… 3 Hepatobiliary malignancy causes obstruction in 70–90% of patients, causing similar complications. 1 – 3 Prior to the use of stents, the primary treatment for biliary obstruction was surgery, such as cholecystojejunostomy or choledochojejunostomy. 4 The endoscopic placement of biliary stents was first introduced in the early 1980s.…”