Antireflux biliary stents: are they the solution to stent occlusions?
Endoscopic insertion of plastic or metal stents is a well-established treatment for malignant biliary obstruction. The major limitation of this technique is stent occlusion. Duodenobiliary reflux has been considered a key contributor to stent occlusion. The presence of plant fibers in 35% to 60% of occluded stents on confocal laser microscopy has further confirmed the presence of reflux when the stent is placed across the papilla. Antireflux stents address this problem by allowing normal antegrade flow but preventing reflux. Recent studies comparing these antireflux stents with the standard Tannenbaum stents have shown significantly prolonged patency. Although initial results are encouraging, larger randomized trials are required to establish efficacy.
Reddy
D Nageshwar
DN
Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad-500 082, India. aigindia@yahoo.co.in
Banerjee
Rupa
R
Choung
Ong Wai
OW
D001655:Bile Reflux / Q000601:surgery*; D001661:Biliary Tract Neoplasms / Q000601:surgery; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D008670:Metals; D010166:Palliative Care; D010969:Plastics; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects* / Q000592:standards / Q000639:trends
D008670:Metals; D010969:Plastics