A Novel Biliary Plastic Stent With a Centrally Located Flap: Initial Clinical Experience in Three Cases

Endoscopic biliary plastic stent (PS) insertion is standard for maintaining bile flow, but migration and dislodgement persist as important challenges. We developed the cross range flap stent (CRF stent), a 7 Fr, 7 cm straight-type PS. Unlike conventional stents with flaps at both ends, the CRF stent features flaps and flap holes at the intestinal end and the center to improve stability and to prevent migration. This report describes three consecutive early cases for which the CRF stent was used for distal malignant biliary stricture caused by pancreatic cancer, acute cholangitis caused by common bile duct stones, and prevention of cholangitis after endoscopic papillectomy. In all cases, the CRF stent was placed easily using its integrated delivery system. No migration or occlusion was observed during the observation periods. The unique centrally located flap appears to be particularly effective for short obstructions and for various clinical conditions. Further largescale comparative studies must be conducted, but the CRF stent has shown potential to minimize stentrelated adverse events.