Othman AAA. Stent selection in elderly biliary drainage: A pragmatic guide from benign to malignant. World J Gastrointest Endosc 2026; 18(1): 116517 [DOI: 10.4253/wjge.v18.i1.116517]
Corresponding Author of This Article
Amira A A Othman, PhD, MD, Lecturer, Principal Investigator, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg
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Medicine, General & Internal
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Editorial
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 16, 2026 (publication date) through Jan 15, 2026
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Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Othman AAA. Stent selection in elderly biliary drainage: A pragmatic guide from benign to malignant. World J Gastrointest Endosc 2026; 18(1): 116517 [DOI: 10.4253/wjge.v18.i1.116517]
World J Gastrointest Endosc. Jan 16, 2026; 18(1): 116517 Published online Jan 16, 2026. doi: 10.4253/wjge.v18.i1.116517
Stent selection in elderly biliary drainage: A pragmatic guide from benign to malignant
Amira A A Othman
Amira A A Othman, Department of Internal Medicine, Suez University, Suez 43511, Egypt
Author contributions: Othman AAA conceptualized the editorial theme, reviewed the relevant literature, and wrote the manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amira A A Othman, PhD, MD, Lecturer, Principal Investigator, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg
Received: November 13, 2025 Revised: November 30, 2025 Accepted: January 4, 2026 Published online: January 16, 2026 Processing time: 63 Days and 8.9 Hours
Abstract
The aging global population presents a growing challenge in interventional endoscopy, making the study by Sugimoto et al both timely and relevant. Their retrospective analysis provides crucial data to resolve a common clinical dilemma: Plastic stent (PS) or metal stent (MS) for endoscopic ultrasound-guided biliary drainage in patients aged 70 and older? This editorial contextualizes their key finding, that PS and MS offer comparable patency in mixed cohorts, but MS significantly prolongs time to recurrent biliary obstruction in malignant cases without antegrade stenting, into a practical decision-making framework. We argue that for benign disease, the ease of PS reintervention is paramount in a frail population. Conversely, for malignancy, the goal shifts to maximizing stent patency to minimize the physical and psychological burden of repeated procedures, firmly favoring the use of MS. This work is a significant step toward personalized, age-specific biliary drainage strategies, and we discuss the imperative for future prospective trials to solidify these recommendations.
Core Tip: With population aging, endoscopic ultrasound-guided biliary drainage is increasingly performed in frail, comorbid patients. The study by Sugimoto et al provides critical evidence that stent selection in elderly patients should be individualized: Plastic stents are suitable for benign conditions due to easier exchange and reintervention, while metal stents better serve malignant obstruction by offering longer patency and reducing repeat procedures. This editorial integrates their results into a pragmatic, patient-centered framework for geriatric endoscopic practice and underscores the urgent need for prospective, multicenter studies to define optimal stent choice and procedural strategies in this vulnerable population.
