Efficacy and safety of the covered Wallstent in patients with distal malignant biliary obstruction

Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction

“…In addition, another study, by use of wire-guided intraductal ultrasonography to diagnose cystic duct invasion by the tumor, documented cystic duct involvement to be an important risk factor for cholecystitis. 15 Therefore, cystic duct invasion of tumor causing insufficient drainage can be primary concern for the risk of cholecystitis.…”

“…[16][17][18] Also, recent reports documented an incidence of cholecystitis to be 5.8% to 11.5% with the use of covered stents. 9,14,15 Theoretically, the open interstices of the uncovered stents can allow sufficient GB drainage and avoidance of cholecystitis. However, cholecystitis is well documented after placement of both uncovered metal and plastic stents.…”

Management of an occluded biliary metallic stent

“…The most common cause of SEMS occlusion is tumor ingrowth, which accounted for 60%-90% of all SEMS occlusion [14][15][16][17][18][19] . This complication is more common in uncovered SEMS, which has an open-mesh, resulting in tissue growing into the stent easily [20,21] . To overcome the problem of tumor ingrowth, a covered stent has been introduced, a membrane made of polyurethane and polyethylene designed to cover the mesh, and therefore tissue and tumor cannot grow into the SEMS lumen.…”

Pancreato-Biliary Cancers – Diagnosis and Management

“…As with plastic stents, endoscopic placement of SEM stents has been shown to provide similar overall survival to surgical decompression but is more cost-effective and better quality of life (Knyrim et al, 1993;Prat et al, 1998). The concurrent use of chemotherapeutic agents in patients palliated with SEM stents does not increase the risk for ascending cholangitis (Nakai et al, 2005).…”