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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 10, 2016; 8(3): 143-156
Published online Feb 10, 2016. doi: 10.4253/wjge.v8.i3.143
Biliary and pancreatic stenting: Devices and insertion techniques in therapeutic endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography
Benedetto Mangiavillano, Nico Pagano, Todd H Baron, Monica Arena, Giuseppe Iabichino, Pierluigi Consolo, Enrico Opocher, Carmelo Luigiano
Benedetto Mangiavillano, Unit of Gastroenterology and Digestive Endoscopy, General Hospital of Sanremo, 18038 Sanremo, Italy
Nico Pagano, Unit of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Todd H Baron, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC 27599, United States
Monica Arena, Giuseppe Iabichino, Carmelo Luigiano, Unit of Digestive Endoscopy, San Paolo Hospital, 20142 Milano, Italy
Pierluigi Consolo, Endoscopy Unit, University Hospital “G. Martino”, 98125 Messina, Italy
Enrico Opocher, Department of Surgery, Unit of Hepatobiliopancreatic and Digestive Surgery, San Paolo Hospital, University of Milan, 20142 Milano, Italy
Author contributions: Mangiavillano B, Pagano N and Luigiano C designed research and wrote, edited and finalized the text; Arena M, Iabichino G and Consolo P performed literature search and analyzed the data; Baron TH and Opocher E reviewed the paper for important intellectual content.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: 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/
Correspondence to: Benedetto Mangiavillano, MD, Unit of Gastroenterology and Digestive Endoscopy, General Hospital of Sanremo, Via G, Borea 56, 18038 Sanremo, Italy. b_mangiavillano@hotmail.com
Telephone: +39-0184-536870 Fax: +39-0184-536875
Received: July 30, 2015
Peer-review started: July 31, 2015
First decision: September 29, 2015
Revised: October 7, 2015
Accepted: November 23, 2015
Article in press: November 25, 2015
Published online: February 10, 2016
Processing time: 185 Days and 15.6 Hours
Abstract

Stents are tubular devices made of plastic or metal. Endoscopic stenting is the most common treatment for obstruction of the common bile duct or of the main pancreatic duct, but also employed for the treatment of bilio-pancreatic leakages, for preventing post- endoscopic retrograde cholangiopancreatography pancreatitis and to drain the gallbladder and pancreatic fluid collections. Recent progresses in techniques of stent insertion and metal stent design are represented by new, fully-covered lumen apposing metal stents. These stents are specifically designed for transmural drainage, with a saddle-shape design and bilateral flanges, to provide lumen-to-lumen anchoring, reducing the risk of migration and leakage. This review is an update of the technique of stent insertion and metal stent deployment, of the most recent data available on stent types and characteristics and the new applications for biliopancreatic stents.

Keywords: Biliary stent; Pancreatic stent; Endoscopic retrograde cholangiopancreatography; Self-expandable metal stent; Endoscopic ultrasonography

Core tip: Biliary and pancreatic stents have become one of the major advances made in therapeutic endoscopy and the endoscopic placement of these devices has a universally recognized role in the management of numerous pancreatico-biliary diseases. This review is an update of the technical considerations and available devices for biliary and pancreatic stenting.