Use of fully covered self-expanding metal stents in benign biliary diseases

Table 1 Commercially available biliary self-expanding metal stents

Manufacterer	Model	Material	Deployed diameters (mm) and lengths (cm)
Boston scientific	Fully covered Wallflex	Platinol covered with permalume	8 or 10 mm
			4, 6, 8 cm
Taewoong Medical	S-Type fully covered	Nitinol covered with silicone	6, 8 or 10 mm
			4-15 cm
M.I. Tech	Hanarostent covered, with lasso or with anchoring flaps	Nitinol covered with silicone	10 mm
			4-10 cm
Standard SciTech	Biliary covered Bonastent with flared ends	Nitinol covered with silicone	10 mm
			4-10 cm
Ella-CS	Nitinella plus	Nitinol covered with silicone	8 or 10 mm
			4-6-8-10 cm
ConMed	Gore viabil with or without holes and with fins	Nitinol covered with ePTFE/FEP (gore tex)	8 or 10 mm
			4-6-8-10 cm

Table 2 Indications for the use of biliary fully covered self-expanding metal stents

Treatment of benign biliary strictures
- Postcholecystectomy
- Post liver transplantation
- Chronic pancreatitis
- Papillary stenosis
- Bile duct stones and cholangitis
- Parasitic biliary infections
-Other forms of surgical biliary interventions and less frequent medical diseases such as primary sclerosing cholangitis or autoimmune pancreatitis
Treatment of biliary leaks
Sealing of papillary area perforations and bleeding after ERCP and biliary sphincterotomy
Extraction of biliary uncovered SEMS
EUS-guided biliary drainage

ERCP: Endoscopic retrograde cholangiopancreatography; SEMS: Self-expanding metal stent; EUS: Endoscopic ultrasound.

Table 3 Some studies on covered self-expanding metal stents for benign biliary strictures with more than 10 patients

Author	No. ofpatients	Type ofstent	BBS etiology	Mean time to removal (mo)	Clinical success (%)
Cantu[22]	14	PCSEMS	CP	21	37.50
Kahaleh[23]	79	PCSEMS	CP/OLT/BS/IM/PS	4	90
Mahajan[24]	44	FCSEMS	CP/OLT/BS/IM/PS	3.3	83
Traina[25]	16	FCSEMS	OLT/LRLT	2	81
Park[13]	43	FCSEMS	CP/OLT/BS/PS	6	84
García- ano[26]	14	FCSEMS	IM/BS	5.5	78.50
Chaput[10]	22	PCSEMS	OLT	2	52.60
García-Pajares[27]	22	FCSEMS	OLT	3.2	95.50
Behm[28]	22	PCSEMS	CP	5	72.70

PCSEMS: Partially covered self-expanding metal stents; FCSEMS: Fully covered self-expanding metal stents; CP: Chronic pancreatitis; OLT: Orthotopic liver transplantation; BS: Biliary stone disease; IM: Inflammatory; PS: Post-surgery; LRLT: Living-related liver transplantation; BBS: Benign boliary strictures.