Metallic stents in biliary disease

Abstract

SummaryBiliary endoprostheses, used for the palliation of malignant bile duct obstruction, have conventionally been made of plastic and their main disadvantages have been migration and occlusion. The problem of migration has largely been solved but occlusion still occurs in up to 30% of cases due to bile encrustation. Increasing the lumen size decreases the occlusion rate but increases the number of serious complications occurring at the time of stent insertion. Metallic stents, which can be introduced over a very small calibre delivery catheter and which achieve a large internal lumen diameterfollowing insertion, have recently become available. Initial studies with these stents have demonstrated a significantly lower occlusion rate and fewer complications associated with their insertion. In addition to their use in malignant biliary strictures, metallic stents have also been used in the treatment of resistant benign biliary strictures and the initial results appear promising. This article describes the v...