Current status and progress of fully covered selfexpandable 〖JP2〗metal stents in the treatment of benign biliary and pancreatic ductal strictures

Though the primary data on fully covered self expandable metal stents (FCSEMS) in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging, the risks including stent translocation, biliary infection, pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first line treatment of benign biliary strictures in routine practice. FCSEMS is effective in treating benign pancreatic ductal strictures, but it is also associated with a high rate of stent trans location. To overcome this problem, FCSEMS with better conformability and flared ends need to be designed. There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents. However, no such complication was reported. Given the uncertain long term efficacy and safety of FCSEMS for benign pancreatic ductal strictures, their use may be reserved for the management of refractory, symptomatic benign strictures only in  selected groups of patients.