Endoscopic Stents for the Biliary Tree and Pancreas.

OPINION STATEMENT: PURPOSE OF REVIEW: To review the recently published literature on biliary and pancreatic stents.

RECENT FINDINGS: Covered self-expanding metal stents (SEMS) are increasingly being used in the endoscopic management of benign biliary strictures. Given the costs associated with SEMS, plastic stents are still the most commonly used stents. In this setting, SEMS are preferred over plastic stents for palliation of malignant biliary strictures due to superior patency and have a role in preoperative management of malignant biliary strictures. While plastic stents are predominantly used for management of pancreatic strictures, newer endoscopic ultrasound (EUS)-guided lumen-apposing SEMS have been increasingly used in management of pancreatic fluid collections. EUS-guided SEMS also enable safe transmural drainage of gall bladder and bile ducts in benign and malignant conditions. Endoscopic management is the first line treatment for multiple pancreatobiliary disorders. EUS-guided interventions have widened the scope of endoscopic management and decreased the need for surgical intervention. Further studies are needed to determine the safety and cost effectiveness of SEMS in benign pancreatic disorders.