title: Self-expandable metal stents in malignant biliary obstruction.
abstract: Malignant biliary obstruction can be due to direct tumor infiltration, extrinsic compression, adjacent inflammation, desmoplastic reaction from tumors or, more commonly, a combination of the above factors. Pancreatic cancer is the most common cause of malignant biliary obstruction, and jaundice occurs in 70-90% of the patients during the course of the disease. Compared with the uncovered metal stents, covered metal stents have longer patency and a lower rate of tumor ingrowth, but have a higher rate of stent migration. To combat the occlusion and provide an antitumor effect, drug-eluting stents were developed. A duodenal stricture complicates biliary stent placement in 10-20% of patients with distal biliary obstruction due to pancreatic cancer. When both strictures are considered, a biliary stent can be placed either preceding or following duodenal stent placement. Complications of self-expandable metal stents include stent occlusion, stent migration, cholecystitis and pancreatitis.
authors.affiliation: Department of Gastroenterology, Hepatology, and Nutrition, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
authors.forename: Sathya
authors.initials: S
authors.lastname: Jaganmohan
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lee
mesh_terms: D001661:Biliary Tract Neoplasms / Q000150:complications*; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D004322:Drainage; D054855:Drug-Eluting Stents; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D006801:Humans; D008670:Metals; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D015607:Stents / Q000009:adverse effects
chemical_list: D008670:Metals