Current status and issues regarding biliary stenting in unresectable biliary obstruction


Corresponding: Takao Itoi, Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Email:


In the present review, we describe the current status of biliary stenting in patients with unresectable malignant biliary strictures. Self-expandable metallic stents (SEMS) are the ideal biliary stent for both distal and hilar biliary strictures, although in terms of distal biliary strictures, there is still some debate as to the selection of covered or uncovered SEMS, suprapapillary or transpapillary stent placement, side-by-side or stent-in-stent placement, unilateral or bilateral stent placement and thenecessity for sphincterotomy. Further high-quality randomized controlled trials for these procedures are warranted.