抄録
Endoscopic biliary stenting (EBS) is a well-established palliative treatment for unresectable malignant biliary strictures, for which plastic tube stents (PSs) and self-expandable metallic stents (SEMSs) are most commonly used. EBS plays an important role in maintaining patients’ condition and in determining subsequent prognosis and quality of life. SEMSs are expected to be more suitable for unresectable malignant biliary strictures according to the Japanese guidelines. SEMSs also proved more advantageous in reducing the number of reintervention sessions and the overall treatment cost. However, U-SEMSs are usually difficult to remove after placement and thereby, limit reintervention in cases of U-SEMS obstruction.
Selection of an SEMS with longer patency than a PS is expected to increase the number of cases that benefit from SEMSs. However, if U-SEMS placement or reintervention for U-SEMS obstruction is unsuccessful, patient relief from the condition and determining the subsequent prognosis and quality of life of patients might be impossible.
Therefore, easy, safe, and effective U-SEMS placement and familiarization with the U-SEMS placement with consideration of the reintervention are necessary. In this regard, covered SEMS is a better choice for patients with unresectable malignant distal biliary because its addresses the issue of removability.
