Endoscopic management of occluded biliary uncovered metal stents: A multicenter experience

Figure 1 The reasons for stent occlusion (A, B) and the management of occluded self-expanding metal stents (C-E). A: Cholangiogram showing self-expanding metal stent (SEMS) occlusion by tumor ingrowth (arrow); B: Endoscopic view showing the distal end of a SEMS completely occluded by tumor overgrowth; C: Insertion of a new SEMS within the distally occluded stent; D: The second SEMS (arrows) was placed to resolve the occlusion by tumor overgrowth; E: Plastic biliary stent (arrowheads) passed through the occluded SEMS (arrows) that had been placed for palliation of pancreatic carcinoma.

Figure 2 Patency of different stent (A-C) and survival after first self-expanding metal stent occlusion (D). A: Patency of 3 self-expanding metal stent (SEMS) until first occlusion; B: Patency of second SEMS vs overall plastic stent patency; C: Patency of second SEMS vs first plastic stent; D: Survival after first SEMS occlusion.