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Recent years have seen the development and commercial release of partially and fully covered biliary self-expandable metal stents. These devices, in theory, should be less susceptible to tumor ingrowth and subsequent clogging, and are removable, but can also migrate out of position and possibly increase the risk for cholecystitis.
In the current meta-analysis, researchers compared the performance of covered versus uncovered stents in treating distal malignant biliary strictures. Data came from 11 randomized, controlled trials involving nearly 1300 patients. Results were as follows:
Stent failure and patient mortality did not differ between devices.
Stent migration and sludge formation were each far more likely with covered versus uncovered ste…