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Covered Metal Stenting

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Advanced Therapeutic Endoscopy for Pancreatico-Biliary Diseases

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Abstract

Endoscopic biliary drainage is the mainstay of treatment for benign or malignant biliary obstruction. Endoprostheses for biliary drainage include plastic and metal stents. Uncovered metal stents are superior to plastic stents in terms of patency. However, tissue ingrowth and stent dysfunction are common through their bare wire mesh. Covered metal stents have been developed to overcome tissue ingrowth and prolong stent patency. Easy removability of covered metal stents makes them an attractive option for benign biliary obstructions. However, migration is an important drawback with covered stents. Currently available covered metal stents differ according to their structure, stent and covering material and mechanical properties. A number of studies have demonstrated their efficacy in benign as well as malignant biliary strictures. The safety, efficacy and ease of removability of covered metal stents have encouraged their use in non-stricture benign biliary diseases like bile leaks, perforation, bile duct stones and bleeding. The “battle of superiority” between covered and uncovered metal stents continues with contrasting results in recent studies. The choice of covered or uncovered metal stents should be individualized to the needs of each patient. Recent developments in covered metal stents include different antimigration designs, antireflux properties and drug-eluting capabilities.

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Authors and Affiliations

  1. Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661, Somajiguda, Hyderabad, Telangana, 500082, India

    Nabi Zaheer M.D., D.N.B, D. Nageshwar Reddy M.D., D.M., D.Sc., F.A.M.S. & Sundeep Lakhtakia M.D., D.N.B., D.M

  2. World Endoscopy Organisation, Munich, Germany

    Nabi Zaheer M.D., D.N.B, D. Nageshwar Reddy M.D., D.M., D.Sc., F.A.M.S. & Sundeep Lakhtakia M.D., D.N.B., D.M

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  1. Nabi Zaheer M.D., D.N.B
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  2. D. Nageshwar Reddy M.D., D.M., D.Sc., F.A.M.S.
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  3. Sundeep Lakhtakia M.D., D.N.B., D.M
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  1. Department of Internal Medicine, School of Medicine, University of Tokai, Isehara, Kanagawa, Japan

    Tetsuya Mine

  2. Sankikai Medical Corporation, Yokohama, Kanagawa, Japan

    Rikiya Fujita

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Zaheer, N., Reddy, D.N., Lakhtakia, S. (2019). Covered Metal Stenting. In: Mine, T., Fujita, R. (eds) Advanced Therapeutic Endoscopy for Pancreatico-Biliary Diseases. Springer, Tokyo. https://doi.org/10.1007/978-4-431-56009-8_28

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