The Past, Present, and Future of Endoscopic Management for Biliary Strictures: Technological Innovations and Stent Advancements

Overview

Journal Front Med (Lausanne)

Specialty General Medicine

Date 2024 Dec 13

PMID 39669990

Authors

Dong-Jin Ni

Qi-Fan Yang

Lu Nie

Jian Xu

Si-Zhe He

Jun Yao

Affiliations

Soon will be listed here.

Abstract

Biliary stricture can be induced by intrinsic narrowing and extrinsic compression, with the majority of cases being malignant. Clinically, distinguishing between benign and malignant biliary strictures remains a considerable challenge, and the ongoing disagreement over the optimal choice of biliary stents significantly influences treatment strategies and impacts patients' survival and prognosis. The utilization and advancement of endoscopic techniques have heightened the diagnostic sensitivity for biliary strictures. Concurrently, innovative technologies such as endoscopic ultrasound and magnetic compression anastomosis emerge as viable alternatives when endoscopic retrograde cholangiopancreatography (ERCP) is not an option, providing fresh insights for the clinical management of these patients. Traditional plastic and metal stents, characterized by their complex application and limited scope, have been unable to fully satisfy clinical needs. The introduction of novel stent varieties has notably improved this scenario, marking a considerable progression towards precision medicine. However, the clinical validation of the diverse stent materials available is incomplete. Hence, a thorough discussion on the present state and evolving trends of biliary stents is warranted.

References

Choudhury S, Asthana S, Homer-Vanniasinkam S, Chatterjee K . Emerging trends in biliary stents: a materials and manufacturing perspective. Biomater Sci. 2022; 10(14):3716-3729. DOI: 10.1039/d2bm00234e. View

Song G, Zhao H, Liu Q, Fan Z . A review on biodegradable biliary stents: materials and future trends. Bioact Mater. 2022; 17:488-495. PMC: 8968460. DOI: 10.1016/j.bioactmat.2022.01.017. View

Alegiani F, Pericoli Ridolfini F . A case of thrombotic thrombocytopenic purpura. A search for a definite therapeutic approach. Haematologica. 1986; 71(6):518-9. View

Li Y, Wang Y, Shen Z, Miao F, Wang J, Sun Y . A biodegradable magnesium alloy vascular stent structure: Design, optimisation and evaluation. Acta Biomater. 2022; 142:402-412. DOI: 10.1016/j.actbio.2022.01.045. View

Park C, Park S, Jung J, Jung E, Kim J, Park D . Comparative Efficacy of Various Stents for Palliation in Patients with Malignant Extrahepatic Biliary Obstruction: A Systematic Review and Network Meta-Analysis. J Pers Med. 2021; 11(2). PMC: 7912345. DOI: 10.3390/jpm11020086. View

Monk B, Tewari K, Puthawala A, Syed A, Haugen J, Burger R . Treatment of recurrent gynecologic malignancies with iodine-125 permanent interstitial irradiation. Int J Radiat Oncol Biol Phys. 2002; 52(3):806-15. DOI: 10.1016/s0360-3016(01)02728-6. View

MacFadyen Jr B, Vecchio R, Ricardo A, Mathis C . Bile duct injury after laparoscopic cholecystectomy. The United States experience. Surg Endosc. 1998; 12(4):315-21. DOI: 10.1007/s004649900661. View

Zong J, He Q, Liu Y, Qiu M, Wu J, Hu B . Advances in the development of biodegradable coronary stents: A translational perspective. Mater Today Bio. 2022; 16:100368. PMC: 9352968. DOI: 10.1016/j.mtbio.2022.100368. View

Koike H, Iwasawa K, Ouchi R, Maezawa M, Kimura M, Kodaka A . Engineering human hepato-biliary-pancreatic organoids from pluripotent stem cells. Nat Protoc. 2021; 16(2):919-936. PMC: 8212777. DOI: 10.1038/s41596-020-00441-w. View

10.

Johnson C, Luke A, Jacobsen C, Novak N, Dion G . State of the Science in Tracheal Stents: A Scoping Review. Laryngoscope. 2021; 132(11):2111-2123. DOI: 10.1002/lary.29904. View

11.

Jan N, Madni A, Khan S, Shah H, Akram F, Khan A . Biomimetic cell membrane-coated poly(lactic--glycolic acid) nanoparticles for biomedical applications. Bioeng Transl Med. 2023; 8(2):e10441. PMC: 10013795. DOI: 10.1002/btm2.10441. View

12.

Han S, Kahaleh M, Sharaiha R, Tarnasky P, Kedia P, Slivka A . Probe-based confocal laser endomicroscopy in the evaluation of dominant strictures in patients with primary sclerosing cholangitis: results of a U.S. multicenter prospective trial. Gastrointest Endosc. 2021; 94(3):569-576.e1. DOI: 10.1016/j.gie.2021.03.027. View

13.

Ghazi R, AbiMansour J, Mahmoud T, Martin J, Law R, Levy M . Uncovered versus fully covered self-expandable metal stents for the management of distal malignant biliary obstruction. Gastrointest Endosc. 2023; 98(4):577-584.e4. DOI: 10.1016/j.gie.2023.05.047. View

14.

Kwon C, Ko K, Hahm K, Kang D . Functional self-expandable metal stents in biliary obstruction. Clin Endosc. 2013; 46(5):515-21. PMC: 3797937. DOI: 10.5946/ce.2013.46.5.515. View

15.

Kim J, Ha D, Han E, Choi Y, Koh J, Joo I . Feasibility and safety of a novel 3D-printed biodegradable biliary stent in an in vivo porcine model: a preliminary study. Sci Rep. 2022; 12(1):15875. PMC: 9508112. DOI: 10.1038/s41598-022-19317-y. View

16.

Gimenez M, Palermo M, Houghton E, Acquafresca P, Finger C, Verde J . BIODEGRADABLE BILIARY STENTS: A NEW APPROACH FOR THE MANAGEMENT OF HEPATICOJEJUNOSTOMY STRICTURES FOLLOWING BILE DUCT INJURY. PROSPECTIVE STUDY. Arq Bras Cir Dig. 2016; 29(2):112-6. PMC: 4944748. DOI: 10.1590/0102-6720201600020012. View

17.

Boyer C, Boktor M, Samant H, White L, Wang Y, Ballard D . 3D Printing for Bio-Synthetic Biliary Stents. Bioengineering (Basel). 2019; 6(1). PMC: 6466390. DOI: 10.3390/bioengineering6010016. View

18.

Chong T, Fu D, Li H, Zhang H, Zhang P, Gan W . Rapamycin inhibits formation of urethral stricture in rabbits. J Pharmacol Exp Ther. 2011; 338(1):47-52. DOI: 10.1124/jpet.110.178624. View

19.

Ahmad J . Metal, magnet or transplant: options in primary sclerosing cholangitis with stricture. Hepatol Int. 2018; 12(6):510-519. DOI: 10.1007/s12072-018-9906-6. View

20.

Lee H, Won D, Park S, Park Y, Kim J, Han G . 3D-printed versatile biliary stents with nanoengineered surface for anti-hyperplasia and antibiofilm formation. Bioact Mater. 2024; 37:172-190. PMC: 10972844. DOI: 10.1016/j.bioactmat.2024.03.018. View