Fully Covered vs. Uncovered Metal Stents for Biliary Obstruction in Pancreatic Cancer

There is an ongoing brisk debate about the relative merits and downsides to using fully covered self-expanding metal biliary stents (FCSEMS) versus uncovered metal biliary stents (UCSEMS) in patients with biliary obstruction secondary to pancreatic cancer. Covered stents are removable but can migrate, potentially causing cholecystitis if the cystic duct orifice is obstructed. Uncovered stents have a presumed lower risk for cholecystitis but higher rates of tissue ingrowth, and they are nonremovable. Now, new comparative data are available from a randomized study.

The multicenter, international study comprised 119 patients with pancreatic cancer who were scheduled to undergo neoadjuvant therapy and required biliary drainage. Fifty patients re…