The perfect biliary plastic stent: the search goes on

Abstract

The introduction of biliary plastic stents has been a landmark achievement in the field of endoscopic retrograde cholangiopancreatography, ensuring minimally invasive and highly effective relief of the obstructed biliary system. Attempts to improve the patency and avoid complications after biliary plastic stenting have led to several innovations, but complications due to stent occlusion are still frequent. Because these complications are clinically relevant, and may guide stent choice and patient management, efforts have been made to elucidate the causes of and ways to prevent occlusion of indwelling stents. In this narrative review we focus on biliary plastic stents and discuss the mechanisms of stent occlusion, existing evidence on salient outcomes, as well as options to overcome existing limitations and prolong plastic stent patency.

Feasibility and safety of choledochotomy primary closure in laparoscopic common bile duct exploration without biliary drainage: a retrospective study

“…However, patients still need to undergo placement of the nasobiliary duct or biliary stent by ERCP preoperatively or intraoperatively to help the bile duct heal after PCCBD 9 , 10 . Both intraoperative and preoperative placement of biliary stents through ERCP have complications such as occlusion and migration, which may require repeat removal or replacement after surgery 11 . A second ERCP may be needed to remove the implanted biliary stent.…”