Endoscopic Stents for the Biliary Tree and Pancreas

Area of Science:

• Gastroenterology
• Endoscopic Interventions

Background:

• Biliary and pancreatic stents are crucial in managing various pancreatobiliary disorders.
• Plastic stents remain common due to cost, while self-expanding metal stents (SEMS) offer advantages in specific scenarios.

Purpose of the Study:

• To review recent literature on the application and efficacy of biliary and pancreatic stents.
• To evaluate the evolving role of different stent types in endoscopic management.

Main Methods:

• Literature review of recently published studies on biliary and pancreatic stents.
• Analysis of stent types, including plastic stents and covered self-expanding metal stents (SEMS).
• Focus on endoscopic management, including endoscopic ultrasound (EUS)-guided interventions.

Main Results:

• Covered SEMS are increasingly used for benign biliary strictures.
• SEMS demonstrate superior patency over plastic stents for malignant biliary stricture palliation and preoperative management.
• Endoscopic ultrasound-guided lumen-apposing SEMS are increasingly used for pancreatic fluid collections and transmural drainage of gallbladder and bile ducts.
• Endoscopic management, particularly EUS-guided interventions, is becoming the first-line treatment, reducing surgical needs.

Conclusions:

• Endoscopic management is the primary approach for pancreatobiliary disorders.
• EUS-guided interventions expand endoscopic capabilities, potentially decreasing surgical interventions.
• Further research is required to establish the safety and cost-effectiveness of SEMS in benign pancreatic disorders.