SEMS and Sensibility: Self-Expandable Metal Stents for Malignant Biliary Obstruction—Are Stent Characteristics Important?

Excerpt

Self-expandable metal stents (SEMSs) are an essential component of endoscopic treatment of malignant biliary strictures. Several studies have compared SEMS with plastic stents for palliative therapy of patients with malignant obstruction of the bile duct [1], particularly patients with an expected survival longer than 3 months, and preoperatively [2], including, but not limited to, those receiving neoadjuvant therapy. SEMS are consistently associated with longer stent patency and fewer re-interventions compared with plastic stents. In the preoperative setting, the two stent types do not differ significantly in terms of surgical morbidity or mortality [2]. The use of SEMS in distal malignant biliary obstruction is recommended by all major endoscopy associations, including the European Society of Gastrointestinal Endoscopy [3]. …