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Updated: Jun 18, 2026
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Clogging of biliary endoprostheses: a new perspective
P P Coene1, A K Groen, J Cheng
1Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
Gut
|August 1, 1990
Summary
Biliary endoprostheses clog over time, especially in contaminated bile. Experimental stents without side holes significantly reduced sludge buildup compared to conventional stents, improving stent patency without increasing complications.
Area of Science:
- Gastroenterology
- Biomaterials Science
Background:
- Endoscopic biliary endoprostheses are standard for treating biliary strictures.
- Stent clogging is a significant clinical problem, reducing treatment efficacy.
- Understanding factors influencing stent encrustation is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate factors affecting biliary endoprosthesis clogging.
- To compare the performance of different stent designs and materials in vitro and in vivo.
- To evaluate the impact of stent side holes on sludge accumulation and patency.
Main Methods:
- In vitro studies using various polymer stents and contaminated/sterilized bile.
- Correlation analysis between polymer frictional coefficient and encrustation.
- In vivo clinical trial comparing conventional stents with experimental stents lacking side holes.
Main Results:
- In vitro encrustation correlated with polymer frictional coefficient and bacterial contamination.
- Side holes significantly increased sludge accumulation but masked material differences.
- Experimental stents without side holes showed significantly less sludge accumulation (p<0.05) without increased morbidity or incomplete drainage.
Conclusions:
- Stent design, particularly the presence of side holes, significantly impacts patency.
- Bacterial contamination and proteins contribute to stent encrustation.
- Omitting side holes in biliary endoprostheses is a promising strategy to improve patency without compromising safety.
