Patients that sufferfrom inoperable malignant distal biliary obstruction have poor quality of lifeand bad prognoses. Endoscopic transpapillary biliary stent placement is anestablished procedure for relieving jaundice and treating cholangitis inpatients with malignant biliary obstruction. Stents that have been endoscopicallyplaced have become the standard of care for biliary drainage with the aim ofimproving hepatic function, relieving jaundice, and reducing adverse effects ofobstruction. Self-expanding metal stents are cost-effective in the treatment ofunresectable malignant biliary obstructions.
Moreover, the stentsoffer longer stent patency and fewer repeat insertions compared with plasticstents. Metal stents have a wider diameter than plastic stents although thecost is 15-40 times the cost of plastic stents. The stents have higher patencyrates and help prevent tumor ingrowth into the stent, which can lead to stentocclusion, when coated with a polymer. There are two types of self-expandingmetal stents: metalnon-covered biliary stents and covered self-expandingmetal stents. Fully-covered self-expanding metal stents and uncovered self-expandingmetal stents provide similar preoperative management of biliary obstruction inpatients with pancreatic cancer receiving neoadjuvant therapy.
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