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Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention

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초록

Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations.

Abstract

Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations.

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Functional Self-Expandable Metal Stents in Biliary Obstruction강대환, 고광현, 권창일, 함기백대한소화기내시경학회 · Clinical Endoscopy2013 · 제46권 제5호Is There Room for Improvement in Increasing the Stent Patency of Biliary Plastic Stents?Jong Jin Hyun, Jung Wan Choe거트앤리버 소화기연관학회협의회 · Gut and Liver2016 · 제10권 제4호A Double-Layered Covered Biliary Metal Stent for the Management of Unresectable Malignant Biliary Obstruction: A Multicenter Feasibility Study정석, 동석호, 문종호, 박진석, 이규택, 이돈행거트앤리버 소화기연관학회협의회 · Gut and Liver2016 · 제10권 제6호A Comparative Study on the Efficacy of Covered Metal Stent and Plastic Stent in Unresectable Malignant Biliary Obstruction고광현, 김진홍, 박상흠, 유교상, 유병무, 유준환, 최재명, 황재철, Do Hyun Park, Dong Ki Lee, Ho Gak Kim, Soon Sun Kim대한소화기내시경학회 · Clinical Endoscopy2012 · 제45권 제1호Partially Covered Metal Stents May Not Prolong Stent Patency Compared to Uncovered Stents in Unresectable Malignant Distal Biliary Obstruction고규봉, 김선주, 김재윤, 문정호, 박상흠, 이윤나, 이태훈, 정윤호, 정일권, 조영신, 차상우, 최영덕, 최현종거트앤리버 소화기연관학회협의회 · Gut and Liver2017 · 제11권 제3호Endoscopic Reintervention for Recurrence of Malignant Biliary Obstruction: Developing the Best StrategyKudo Masatoshi, Takenaka Mamoru거트앤리버 소화기연관학회협의회 · Gut and Liver2022 · 제16권 제4호

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