title: Novel biliary self-expanding metal stents: indications and applications.
abstract: Endoscopic insertion of a self-expanding metal stent (SEMS) through a malignant common bile duct stricture is the first line of palliation for malignant jaundice. Patency of these stents remains a major concern. SEMS dysfunction can result from tumor ingrowth, overgrowth and/or clogging. Initial SEMS modifications involved covering the central part of the stent in order to reduce ingrowth and ultimately increase patency. Fully covered stents became available shortly after reports of their use in human patients. The potential removability and radial strength of SEMS have led to evaluation of their use in new indications including benign biliary strictures, post sphincterotomy bleeding and perforation. Other aspects of development include the addition of features such as anti-reflux valves, drug elution and spontaneous biodegradability. These aspects and their clinical implications are reviewed and discussed.
authors.affiliation: CHU Charleroi et Vésale, ISPPC, Université Libre de Bruxelles, 1 boulevard Zoé Drion, 6000 Charleroi, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Blero
authors.forename: Vincent
authors.initials: V
authors.lastname: Huberty
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology / Q000628:therapy*; D001652:Bile Ducts / Q000473:pathology / Q000601:surgery*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D054855:Drug-Eluting Stents; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy*; D009369:Neoplasms / Q000150:complications*; D000069322:Self Expandable Metallic Stents
keywords: ERCP; benign biliary stricture; biliary leak; biliary stenosis; endoscopy; malignant biliary stricture; plastic stent; self-expanding metal stent