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Uncovered Metallic Stenting

  • Sung-Hoon Moon
Chapter

Abstract

Uncovered metallic stenting is typically used for unresectable distal or hilar malignant biliary obstruction. This chapter describes the approach, mechanical properties, and stenting techniques, as well as the outcome of uncovered metallic stenting in “distal” malignant biliary obstruction. Endoscopic biliary metal stenting is recommended for unresectable distal malignant biliary obstruction when patient life expectancy is longer than 4 months because the outcomes with metal stenting are superior to both surgical drainage and plastic stenting. The self-expandable metal stent is a metallic stent with a small predeployment diameter constrained by a sheath and a large post-deployment diameter when expanded. The mechanical properties of the metal stent are imparted by the stent material, stent mesh design, radial force, axial flexibility, foreshortening, radiopacity, covering membrane, and the anchoring mechanism. The adequate stent length can be measured using a graduated guidewire or the catheter distance measured outside the endoscope. During metal stent deployment, the position of the stent can be adjusted by applying additional traction or recapturing the metal stent. Reintervention for an occluded or migrated stent is also discussed at the end of this chapter.

Keywords

Endoscopic stenting Biliary stent Metal stent Self-expandable metal stent 

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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Hallym University Sacred Heart HospitalHallym University College of MedicineDongan-gu, Anyang, Gyeonggi-doSouth Korea

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