A Plastic Stent to Anchor a Metal Biliary Stent?

Endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay of treatment for patients with malignant biliary strictures. Recent years have seen widespread adoption of the fully covered self-expanding metal stent (FCSEMS) to treat jaundice in these patients. FCSEMSs, unlike partially covered or uncovered stents, have a small but significant risk of migration. In a randomized, controlled trial, researchers assessed the value of placing a plastic stent inside an FCSEMS to help anchor it and reduce migration rates.

Seventy patients with unresectable malignant distal biliary obstruction were randomized to receive either an FCSEMS alone or with a 7Fr double-pigtail stent placed inside it, with one pigtail above the FCSEMS and one pigtail…