pISSN 2636-0004eISSN 2636-0012
pISSN 2636-0004Comparison of the Characteristics of Each Stent for Endoscopic Ultrasound (EUS)-Guided Bile Duct Drainage
| Type of stent | Possible type | Advantage | Disadvantage |
|---|---|---|---|
| Plastic stent | - Single-pigtail stent - Double-pigtail stent |
- Less expensive - Convenience for revision - Less shortening of stent - Less tumor tissue hyperplasia or ingrowth/overgrowth |
- Frequent stent dysfunction including occlusion due to the small diameter of the stent - Possible bile leakage along the stent |
| Fully or partially covered self-expandable metal stent (FCSEMS or PCSEMS) | - PCSEMS or FCSEMS without anti-migrating flanges - PCSEMS or FCSEMS with anti-migrating flanges (unidirectional or bidirectional) |
- Longer stent patency than plastic stent due to larger diameter of the stent - Theoretically less bile leakage |
- Relatively expensive - Side-branch obstruction leading to biloma or hepatic abscess - Stent malposition - Higher rate of stent shortening leading to stent migration |
| Lumen-apposing metal stent (LAMS) | - Only for EUS-guided choledochoduodenostomy - LAMS with bidirectional anchoring flanges but no electrocautery-enhanced tip - LAMS with electrocautery-enhanced tip |
- Largest diameter - Longer stent patency - Shorter procedure time due to one-step creation of the fistula - Omitting unnecessary steps, including balloon dilation - Migration is rare |
- Very expensive - Rare but possible adverse events of significant bleeding or buried LAMS syndrome |