Clinical Gastroenterology Vol.25 No.12(11)

Theme Development of Diagnosis and Therapy for Biliary Tract Diseases
Title Current Topics of Endoscopic Biliary Stenting
Publish Date 2010/11
Author Osamu Togawa Department of Gastroenterology, Saitama Medical University International Medical Center
Author Hiroyuki Isayama Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
Author Yousuke Nakai Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
Author Hirofumi Kogure Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
Author Masao Omata Department of Gastroenterology, Yamanashi Prefectural Central Hospital
Author Kazuhiko Koike Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo
[ Summary ] The cause of biliary strictures (BS) is due to various etiologies, such as pancreatobiliary malignancies, chronic pancreatitis and anastomotic strictures. Endoscopic biliary stenting (EBS) is currently recognized as the first choice for management of BS because of its reduced invasiveness and lower complication rates compared to surgery. EBS is accomplished with plastic stents (PS) and self-expandable metallic stents (SEMS). Because the maximum diameter of PS is 11.5 Fr, PS often occlude in an unexpectedly short period. SEMS was developed to overcome this disadvantage by enlarging the diameter of stents, and has been shown to have longer patency periods than PS in cases of malignancy. While, SEMS placement for benign biliary strictures is still challenging, several studies have reported on the usefulness of covered SEMSes for benign cases. EBS plays an important role in the management of BS, but still presents problems which must be overcome, such as stent occlusion and migration. Recently, drug eluting stents and biodegradable stents have developed and been reported on. Clinical application of these new types of stents is expected.
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