| Theme |
Stenting for Digestive Diseases |
| Title |
Endoscopic Biliary Stenting for Malignant Distal Biliary Obstruction |
| Author |
Hiroki Koda |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Nozomi Okuno |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Takamichi Kuwahara |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Makoto Haba |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Nobumasa Mizuno |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| Author |
Kazuo Hara |
Department of Gastroenterology, Aichi Cancer Center Hospital |
| [ Summary ] |
Endoscopic biliary drainage is the first‒line treatment for biliary drainage in patients with malignant distal biliary obstruction. The following types of biliary stents are used for this purpose: plastic stents (PS) and metal stents (MS). MS are further subcategorized into fully‒covered self‒expandable metal stents (FCSEMS), partially‒covered SEMS (PCSEMS), and uncovered SEMS (UCSEMS) based on their design (covered [coated] vs. uncovered). To date, several studies have discussed stent patency, complications, and re‒intervention associated with stent usage, and in recent years SEMS are widely used in clinical practice. The indications for biliary drainage differ between patients with resectable and unresectable lesions; therefore, stent selection needs to be individualized. Detailed pre‒procedural imaging is necessary to ensure a successful procedure for decision‒making regarding the optimal treatment strategy to anticipate and minimize complications. Finally, in cases where drainage is difficult, other methods such as percutaneous transhepatic biliary drainage (PTBD) should be considered without relying exclusively on endoscopic treatment. |