• Biliary stent
• Biodegradable
• Functional coatings
• Shape memory
• Tissue engineering & 3D-printed stent

• biliary stricture
• biodegradable stent
• endoscopy
• polyhydroxyalkanoate
• shape memory
• triamcinolone acetonide

• Animals
• Humans
• Swine
• Plastics
• Constriction, Pathologic/surgery
• Hyperplasia
• Swine, Miniature
• Cholestasis/therapy
• Stents

• 82270700 National Natural Science Foundation of China
• 2023GGXM004 Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau)
• National Natural Science Foundation of China

Endoscopic luminal stenting (ELS) represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract. Previous studies have shown that ELS can provide rapid relief of symptoms related to esophageal, gastric, small intestinal, colorectal, biliary, and pancreatic neoplastic strictures without compromising cancer patients’ overall safety. As a result, in both palliative and neoadjuvant settings, ELS has largely surpassed radiotherapy and surgery as a first-line treatment modality. Following the abovementioned success, the indications for ELS have gradually expanded. To date, ELS is widely used in clinical practice by well-trained endoscopists in managing a wide variety of diseases and complications, such as relieving non-neoplastic obstructions, sealing iatrogenic and non-iatrogenic perforations, closing fistulae and treating post-sphincterotomy bleeding. The abovementioned development would not have been achieved without corresponding advances and innovations in stent technology. However, the technological landscape changes rapidly, making clinicians’ adaptation to new technologies a real challenge. In our mini-review article, by systematically reviewing the relevant literature, we discuss current developments in ELS with regard to stent design, accessories, techniques, and applications, expanding the research basis that was set by previous studies and highlighting areas that need to be further investigated.

• Endoscopic luminal stenting
• Obstruction
• Stricture
• Stenting
• Leak
• Cancer
• Inflammatory bowel disease
• Bariatric surgery

To assess the feasibility and safety of a novel 3D-printed biodegradable biliary stent using polycaprolactone (PCL) in an in vivo porcine model. In this animal study using domestic pigs, biodegradable radiopaque biliary stents made of polycaprolactone (PCL) and barium sulfate were produced using 3D printing and surgically inserted into the common bile duct (CBD) of pigs (stent group, n = 12). Another five pigs were allocated to the control group that only underwent resection and anastomosis of the CBD without stent insertion. To check the position and status of the stents and stent-related complications, follow-up computed tomography (CT) was performed every month. The pigs were sacrificed 1 or 3 months after surgery, and their excised CBD specimens were examined at both the macroscopic and microscopic levels. Three pigs (one in the stent group and two in the control group) died within one day after surgery and were excluded from further analysis; the remaining 11 in the stent group and 3 in the control group survived the scheduled follow-up period (1 month, 5 and 1; and 3 months, 6 and 2 in stent and control groups, respectively). In all pigs, no clinical symptoms or radiologic evidence of biliary complications was observed. In the stent group (n = 11), stent migration (n = 1 at 3 months; n = 2 at 1 month) and stent fracture (n = 3 at 2 months) were detected on CT scans. Macroscopic evaluation of the stent indicated no significant change at 1 month (n = 3) or fragmentation with discoloration at 3 months (n = 5). On microscopic examination of CBD specimens, the tissue inflammation score was significantly higher in the stent group than in the control group (mean ± standard deviation (SD), 5.63 ± 2.07 vs. 2.00 ± 1.73; P = 0.039) and thickness of fibrosis of the CBD wall was significantly higher than that of the control group (0.46 ± 0.12 mm vs. 0.21 ± 0.05 mm; P = 0.012). Despite mild bile duct inflammation and fibrosis, 3D-printed biodegradable biliary stents showed good feasibility and safety in porcine bile ducts, suggesting their potential for use in the prevention of postoperative biliary strictures.

• diseases
• gastroenterology

• Animals
• Cholangiopancreatography, Endoscopic Retrograde
• Cholestasis/therapy
• Constriction, Pathologic/surgery
• Device Removal
• Stents/adverse effects
• Steroids
• Swine
• Swine, Miniature
• Treatment Outcome
• Triamcinolone

• National Research Foundation, Ministry of Science and ICT of Korea
• faculty research grant from the Yonsei University College of Medicine
• research grant from Gangnam Severance Hospital, Yonsei University College of Medicine

• Ablation
• Cholangiocarcinoma
• Interventional radiology
• Liver
• Oncology
• Radiotherapy

• Anti-biofilm formation
• Anti-tumor
• Biliary stent film
• Ofloxacin
• Paclitaxel

• Biodegradable
• Drug-eluting
• Paclitaxel
• Poly(lactic-co-glycolic acid)
• Stent

• 5-fluorouracil
• drug-eluting stent
• gastrointestinal cancer
• self-expanding metal stents

• Antineoplastic Agents/chemistry
• Antineoplastic Agents/therapeutic use
• Drug Development
• Drug Liberation
• Drug-Eluting Stents
• Fluorouracil/chemistry
• Fluorouracil/therapeutic use
• Gastrointestinal Neoplasms/drug therapy
• Humans

• common bile duct
• endoscopic retrograde cholangiopancreatography
• extrahepatic cholestasis
• randomized controlled trial
• stents

Self-expanding metal stents (SEMSs) are currently the gold standard for the localised management of malignant gastrointestinal (GI) stenosis and/or obstructions. Despite encouraging clinical success, in-stent restenosis caused by tumour growth is a significant challenge. Incorporating chemotherapeutic drugs into GI stents is an emerging strategy to provide localised and sustained release of drugs to intestinal malignant tissues to prevent tumour growth. Therefore, the aim of this work was to develop and evaluate a local GI stent-based delivery system that provides a controlled release of 5-fluorouracil (5FU) over a course of several weeks to months, for the treatment of colorectal cancer and cancer-related stenosis/obstructions. The 5FU-loaded GI stents were fabricated via sequential dip-coating of commercial GI stents with a drug-loaded polyurethane (PU) basecoat and a drug-free poly(ethylene-co-vinyl acetate) (PEVA) topcoat. For comparison, two types of commercial stents were investigated, including bare and silicone (Si) membrane-covered stents. The physicochemical properties of the 5FU-loaded stents were evaluated using photoacoustic Fourier-transform infrared (PA-FTIR) spectroscopy, X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and thermal analysis. In vitro release studies in biological medium revealed that the 5FU-loaded stents provided a sustained release of drug over the period studied (18 d), and cell viability, cell cycle distribution and apoptosis assays showed that the released 5FU had comparable anticancer activity against human colon cancer cells (HCT-116) to pure 5FU. This study demonstrates that dip-coating is a facile and reliable approach for fabricating drug-eluting stents (DESs) that are promising candidates for the treatment of GI obstructions and/or restenosis.

• 5-fluorouracil
• dip-coating
• drug-eluting stent
• gastrointestinal cancer
• localised drug delivery

• Gallbladder cancer
• malignant hilar stricture
• metal
• plastic
• stent

Effective endoscopic management is fundamental for the treatment of extrahepatic cholangiocarcinoma (ECC). However, current biliary stents that are widely used in clinical practice showed no antitumor effect. Drug-eluting stents (DESs) may achieve a combination of local chemotherapy and biliary drainage to prolong stent patency and improve prognosis.

To develop novel DESs coated with gemcitabine (GEM) and cisplatin (CIS)-coloaded nanofilms that can maintain the continuous and long-term release of antitumor agents in the bile duct to inhibit tumor growth and reduce systemic toxicity.

Stents coated with different drug-eluting components were prepared by the mixed electrospinning method, with poly-L-lactide-caprolactone (PLCL) as the drug-loaded nanofiber membrane and GEM and/or CIS as the antitumor agents. Four different DESs were manufactured with four drug-loading ratios (5%, 10%, 15%, and 20%), including bare-loaded (PLCL-0), single-drug-loaded (PLCL-GEM and PLCL-CIS), and dual-drug-loaded (PLCL-GC) stents. The drug release property, antitumor activity, and biocompatibility were evaluated in vitro and in vivo to confirm the feasibility and efficacy of this novel DES for ECC.

The in vitro drug release study showed the stable, continuous release of both GEM and CIS, which was sustained for over 30 d without an obvious initial burst, and a higher drug-loaded content induced a lower release rate. The drug-loading ratio of 10% was used for further experiments due to its ideal inhibitory efficiency and relatively low toxicity. All drug-loaded nanofilms effectively inhibited the growth of EGI-1 cells in vitro and the tumor xenografts of nude mice in vivo; in addition, the dual-loaded nanofilm (PLCL-GC) had a significantly better effect than the single-drug-loaded nanofilms (P < 0.05). No significant differences in the serological analysis (P > 0.05) or histopathological changes were observed between the single-loaded and drug-loaded nanofilms after stent placement in the normal porcine biliary tract.

This novel PLCL-GEM and CIS-eluting stent maintains continuous, stable drug release locally and inhibits tumor growth effectively in vitro and in vivo. It can also be used safely in normal porcine bile ducts. We anticipate that it might be considered an alternative strategy for the palliative therapy of ECC patients.

• Extrahepatic cholangiocarcinoma
• Drug-eluting stent
• Local chemotherapy
• Gemcitabine
• Cisplatin
• Biliary obstruction

• Animals
• Bile Duct Neoplasms/drug therapy
• Bile Ducts, Intrahepatic
• Cholangiocarcinoma/drug therapy
• Cisplatin
• Deoxycytidine/analogs & derivatives
• Drug-Eluting Stents
• Feasibility Studies
• Humans
• Mice
• Mice, Nude
• Stents
• Swine
• Gemcitabine

Gemcitabine is clinically used to treat certain types of cancers, including pancreatic and biliary cancer. We investigated the signal transduction pathways underlying the local antitumor effects of gemcitabine-eluting membranes (GEMs) implanted in pancreatic/biliary tumor-bearing nude mice. Here, we report that GEMs increased the E3 ubiquitin ligase c-CBL protein level, leading to degradation of epidermal growth factor receptor (EGFR) in SCK and PANC-1 cells. GEMs decreased the RAS and PI3K protein levels, leading to a reduction in the protein levels of active forms of downstream signaling molecules, including PDK, AKT, and GSK3β. GEM reduced proliferation of cancer cells by upregulating cell cycle arrest proteins, particularly p53 and p21, and downregulating cyclin D1 and cyclin B. Moreover, GEMs reduced the levels of proangiogenic factors, including VEGF, VEGFR2, CD31, and HIF-1α, and inhibited tumor cell migration and invasion by inducing the expression of E-cadherin and reducing that of N-cadherin, snail, and vimentin. We demonstrated that local delivery of gemcitabine using GEM implants inhibited tumor cell growth by promoting c-CBL-mediated degradation of EGFR and inhibiting the proliferation, angiogenesis, and epithelial–mesenchymal transition of pancreatic/biliary tumors. Use of gemcitabine-eluting stents can improve stent patency by inhibiting the ingrowth of malignant biliary obstructions.

• EGFR
• angiogenesis
• biliary duct carcinoma
• drug-eluting stent
• gemcitabine
• pancreatic cancer

• Animals
• Antigens, CD
• Cadherins/metabolism
• Cell Cycle
• Cell Cycle Checkpoints
• Cell Line, Tumor
• Cell Movement/drug effects
• Cell Proliferation
• Cholangiocarcinoma/drug therapy
• Cholangiocarcinoma/metabolism
• Cholangiocarcinoma/pathology
• Cyclin B/metabolism
• Cyclin D1/metabolism
• Deoxycytidine/analogs & derivatives
• Deoxycytidine/pharmacology
• Deoxycytidine/therapeutic use
• Epithelial-Mesenchymal Transition/drug effects
• ErbB Receptors/metabolism
• Female
• Humans
• Hypoxia-Inducible Factor 1, alpha Subunit/metabolism
• Mice
• Mice, Nude
• Pancreas/drug effects
• Pancreatic Neoplasms/drug therapy
• Pancreatic Neoplasms/metabolism
• Platelet Endothelial Cell Adhesion Molecule-1/metabolism
• Proto-Oncogene Proteins c-cbl/metabolism
• Signal Transduction/drug effects
• Ubiquitin-Protein Ligases/metabolism
• Vascular Endothelial Growth Factor A/metabolism
• Vascular Endothelial Growth Factor Receptor-2/metabolism
• Xenograft Model Antitumor Assays
• Gemcitabine

• Biliary tract neoplasms
• Drug delivery systems
• Drug-eluting stent
• Pancreatic neoplasm
• Self expandable metallic stent

There are a variety of causes of intestinal obstruction, with the most common cause being malignant diseases; however, volvulus, inflammatory bowel disease or diverticulitis, radiation injury, ischemia, and pseudo-obstruction can also cause colonic obstruction. These are benign conditions; however, delayed diagnosis of acute intestinal obstruction owing to these causes can cause critical complications, such as perforation. Therefore, high levels of clinical suspicion and appropriate treatment are crucial. There are variable treatment options for colonic obstruction, and endoscopic treatment is known to be a less invasive and an effective option for such. In this article, the authors review the causes of benign colonic obstruction and pseudo-obstruction and the role of endoscopy in treating them.

• Balloon dilatation
• Enteral stent
• Intestinal obstruction

• Cholangiocarcinoma
• Drug-eluting stent
• GI stent
• Nanofiber
• Piperlongumine

Paclitaxel (PTX) could inhibit the growth of fibroblasts, which occurs in proliferative cholangitis and leads to biliary stricture. However, its use has been limited due to poor bioavailability and local administration for short time. This study designed and synthesized a new PTX-conjugated chitosan film (N-succinyl-hydroxyethyl chitosan containing PTX [PTX-SHEC]) and evaluated its safety and efficiency using in vivo and in vitro experiments.

The SHEC conjugated with PTX was confirmed by nuclear magnetic resonance (NMR) and Fourier-transform infrared spectroscopy (FT-IR) measurements. Drug releases in vitro and in vivo were determined using high-performance liquid chromatography. Cell viability in vitro was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Rabbit biliary stricture model was constructed. All rabbits randomly divided into five groups (n = 8 in each group): the sham-operated rabbits were used as control (Group A), Groups B received laparotomies and suture, Group C received laparotomies and covered SHEC suture without the PTX coating, Group D received laparotomies and covered PTX-SHEC suture, and Group E received laparotomies and 1000 μmol/L PTX administration. Liver function tests and residual dosage of PTX from each group were measured by enzyme-linked immunosorbent assay. Histological data and α-smooth muscle actin (SMA) immunohistochemical staining of common bile duct were examined.

NMR and FT-IR indicated that PTX was successfully introduced, based on the appearance of signals at 7.41–7.99 ppm, 1.50 ppm, and 1.03 ppm, due to the presence of aromatic protons, methylene protons, and methyl protons of PTX, respectively. No bile leak was observed. The PTX-conjugated film could slowly release PTX for 4 weeks (8.89 ± 0.03 μg at day 30). The in vitro cell viability test revealed significantly different levels of toxicity between films with and without PTX (111.7 ± 4.0% vs. 68.1 ± 6.0%, P < 0.001), whereas no statistically significant difference was observed among the three sets of PTX-contained films (67.7 ± 5.4%, 67.2 ± 3.4%, and 59.1 ± 6.0%, P > 0.05). Histological examinations revealed that after 28 days of implantment, Groups D and E (but not Group C) had less granulation tissue and glandular hyperplasia in the site of biliary duct injury than Group B. The pattern was more obvious in Group D than Group E. Less α-SMA-positive cells were found in tissue from Groups D and E. Comparing with Group E, the liver function was improved significantly in Group D, including total bilirubin (2.69 ± 1.03 μmol/L vs. 0.81 ± 0.54 μmol/L, P = 0.014), alanine aminotransferase (87.13 ± 17.51 U/L vs. 42.12 ± 15.76 U/L, P = 0.012), and alkaline phosphatase (60.61 ± 12.31 U/L vs. 40.59 ± 8.78 U/L, P < 0.001).

PTX-SHEC film effectively inhibites the myofibroblast proliferation and extracellular matrix over-deposition during the healing process of biliary reconstruction. This original film might offer a new way for reducing the occurrence of the benign biliary stricture.

• Biliary Stricture
• Chitosan
• Paclitaxel
• Proliferative Cholangitis
• Slow-Releasing

A drug-eluting stent for unresectable malignant biliary obstruction was developed to increase stent patency by preventing tumor ingrowth. The safety and efficacy of a new generation of metallic stents covered with a paclitaxel-incorporated membrane using a Pluronic^® mixture (MSCPM-II) were compared prospectively with those of covered metal stents (CMSs) in patients with malignant biliary obstructions.

This study was initially designed as a prospective randomized trial but was closed early because of a high incidence of early occlusion. Therefore, the data were analyzed using the intent-to-treat method. A total of 72 patients with unresectable distal malignant biliary obstructions were prospectively enrolled.

The two groups did not differ significantly in basic characteristics and mean follow-up period (MSCPM-II 194 days vs CMS 277 days, p=0.063). Stent occlusion occurred in 14 patients (35%) who received MSCPM-II and in seven patients (21.9%) who received CMSs. Stent patency and survival time did not significantly differ between the two groups (p=0.355 and p=0.570). The complications were mild and resolved by conservative management in both groups.

There were no significant differences in stent patency or patient survival in MSCPM-II and CMS patients with malignant biliary obstructions.

• Biliary tract neoplasms
• Drug-eluting stents
• Pancreatic neoplasms
• Self expandable metallic stents

The aim of this study was to fabricate a vorinostat (Zolinza™)-eluting nanofiber membrane-coated gastrointestinal (GI) stent and to study its antitumor activity against cholangiocarcinoma (CCA) cells in vitro and in vivo.

Vorinostat and poly(DL-lactide-co-glycolide) dissolved in an organic solvent was sprayed onto a GI stent to make a nanofiber-coated stent using an electro-spinning machine. Intact vorinostat and vorinostat released from nanofibers was used to assess anticancer activity in vitro against various CCA cells. The antitumor activity of the vorinostat-eluting nanofiber membrane-coated stent was evaluated using HuCC-T1 bearing mice.

A vorinostat-incorporated polymer nanofiber membrane was formed on the surface of the GI stent. Vorinostat was continuously released from the nanofiber membrane over 10 days, and its release rate was higher in cell culture media than in phosphate-buffered saline. Released vorinostat showed similar anticancer activity against various CCA cells in vitro compared to that of vorinostat. Like vorinostat, vorinostat released from nanofibers induced acetylation of histone H4 and inhibited histone deacetylases 1⋅3⋅4/5/7 expression in vitro and in vivo. Furthermore, vorinostat nanofibers showed a higher tumor growth inhibition rate in HuCC-T1 bearing mice than vorinostat injections.

Vorinostat-eluting nanofiber membranes showed significant antitumor activity against CCA cells in vitro and in vivo. We suggest the vorinostat nanofiber-coated stent may be a promising candidate for CCA treatment.

• GI stent
• cholangiocarcinoma
• drug eluting
• nanofiber
• vorinostat

• docetaxel
• drug-eluting stent
• esophageal cancer
• esophageal stent
• self-expanding metal stents

• Animals
• Antineoplastic Agents/administration & dosage
• Antineoplastic Agents/chemistry
• Cell Line
• Cell Line, Tumor
• Chemistry, Pharmaceutical/methods
• Docetaxel
• Esophagus/drug effects
• Female
• Humans
• Mice
• Mice, Inbred BALB C
• Mice, Nude
• Stents
• Taxoids/administration & dosage
• Taxoids/chemistry
• Xenograft Model Antitumor Assays/methods

• Pancreatic cancer
• endoscopic ultrasound-guided FNA
• neoadjuvant chemoradiation
• radiofrequency ablation
• self-expanding metal stent
• tumor markers

Many advances have been achieved in biliary stenting over the past 30 years. Endoscopic stent placement has become the primary management therapy to relieve obstruction in patients with benign or malignant biliary tract diseases. Compared with plastic stents, a self-expandable metallic stent (SEMS) has been used for management in patients with malignant strictures because of a larger lumen and longer stent patency. Recently, SEMS has been used for various benign biliary strictures and leaks. In this article, we briefly review the characteristics of SEMS as well as complications of stent placement. We review the current guidelines for managing malignant and benign biliary obstructions. Recent developments in biliary stenting are also discussed.

• Benign
• Biliary stenting
• Malignant
• Self expandable metallic stents

Biliary stenting is clinically effective in relieving both malignant and non-malignant obstructions. However, there are high failure rates associated with tumor ingrowth and epithelial overgrowth as well as internally from biofilm development and subsequent clogging. Within the last decade, the use of prophylactic drug eluting stents as a means to reduce stent failure has been investigated. In this review we provide an overview of the current research on drug eluting biliary stents. While there is limited human trial data regarding the clinical benefit of drug eluting biliary stents in preventing stent obstruction, recent research suggests promise regarding their safety and potential efficacy.

• Bile ducts
• Cholangiocarcinoma
• Endoscopy
• Pancreas

Since the development of uncovered self-expanding metal stents (SEMS) in the 1990s, endoscopic stents have evolved dramatically. Application of new materials and new designs has expanded the indications for enteral SEMS. At present, enteral stents are considered the first-line modality for palliative care, and numerous types of enteral stents are under development for extended clinical usage, beyond a merely palliative purpose. Herein, we will discuss the current status and the future development of lower enteral stents.

• Colon
• Obstruction
• Stent
• Self-expanding metal stents

• Colonic Diseases/diagnosis
• Colonic Diseases/etiology
• Colonic Diseases/therapy
• Colonoscopy/adverse effects
• Colonoscopy/instrumentation
• Colorectal Neoplasms/complications
• Humans
• Intestinal Obstruction/diagnosis
• Intestinal Obstruction/etiology
• Intestinal Obstruction/therapy
• Palliative Care
• Prosthesis Design
• Rectal Diseases/diagnosis
• Rectal Diseases/etiology
• Rectal Diseases/therapy
• Stents
• Treatment Outcome

• and SAXS analysis
• cancer chemotherapy
• controlled release
• docetaxel
• drug eluting stent
• esophageal cancer
• formulation
• polymeric drug delivery system

• Animals
• Delayed-Action Preparations/chemistry
• Delayed-Action Preparations/pharmacology
• Docetaxel
• Drug Delivery Systems/methods
• Esophageal Neoplasms/drug therapy
• Esophagus/drug effects
• Polymers/chemistry
• Stents
• Swine
• Taxoids/administration & dosage
• Taxoids/chemistry

• Drug-eluting stents
• Endoscopy, gastrointestinal
• Stents

Endoscopic stenting is increasingly being used in the management of gastrointestinal luminal obstruction, and has become the current treatment of choice for the palliation of blockage caused by malignant or benign growths. A variety of stents have been developed to enhance the efficacy of the procedure, and improvements are ongoing. In this article, we review the history of, and recent advances in, gastrointestinal stenting. We describe the rationale behind the design as well as the resulting outcome for each stent type.

• Drug-eluting stents
• Endoscopy, gastrointestinal
• Stents

Implantation of self-expanding metal stents (SEMS) is palliation for patients suffering from inoperable malignant obstructions associated with biliary and pancreatic cancers. Chemotherapeutic agent-eluting stents have been developed because SEMS are susceptible to occlusion by tumor in-growth. We reported recently that paclitaxel-eluting SEMS provide enhanced local drug delivery in an animal model. However, little is known about the molecular mechanisms by which paclitaxel-eluting stents attenuate tumor growth. We investigated the signal transduction pathways underlying the antiproliferative effects of a paclitaxel-eluting membrane (PEM) implanted in pancreatic/cholangiocarcinoma tumor bearing nude mice. Molecular and cellular alterations were analyzed in the PEM-implanted pancreatic/cholangiocarcinoma xenograft tumors by Western blot, immunoprecipitation, and immunofluorescence. The quantities of paclitaxel released into the tumor and plasma were determined by liquid chromatography-tandem mass spectroscopy. Paclitaxel from the PEM and its diffusion into the tumor inhibited angiogenesis, which involved suppression of mammalian target of rapamycin (mTOR) through regulation of hypoxia inducible factor (HIF-1) and increased apoptosis. Moreover, implantation of the PEM inhibited tumor-stromal interaction-related expression of proteins such as CD44, SPARC, matrix metalloproteinase-2, and vimentin. Local delivery of paclitaxel from a PEM inhibited growth of pancreatic/cholangiocarcinoma tumors in nude mice by suppressing angiogenesis via the mTOR and inducing apoptosis signal pathway.

• ERCP
• benign biliary stricture
• biliary leak
• biliary stenosis
• endoscopy
• malignant biliary stricture
• plastic stent
• self-expanding metal stent

• 5-Fluorouracil
• Esophageal stent
• In vivo evaluation
• Paclitaxel

• Animals
• Antineoplastic Combined Chemotherapy Protocols/pharmacokinetics
• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Combined Modality Therapy
• Esophageal Neoplasms/drug therapy
• Esophageal Neoplasms/surgery
• Fluorouracil/administration & dosage
• Humans
• Paclitaxel/administration & dosage
• Stents
• Swine
• Tissue Distribution

• Drug eluting stent
• Electrospinning
• Eudragit
• Nanofiber
• pH sensitive polymers

Biliary stents are widely used not only for palliative treatment of malignant biliary obstruction but also for benign biliary diseases. Each plastic stent or self-expandable metal stent (SEMS) has its own advantages, and a proper stent should be selected carefully for individual condition. To compensate and overcome several drawbacks of SEMS, functional self-expandable metal stent (FSEMS) has been developed with much progress so far. This article looks into the outcomes and defects of each stent type for benign biliary stricture and describes newly introduced FSEMSs according to their functional categories.

• Bile ducts, extrahepatic
• Biliary tract
• Drug-eluting stents
• Stents

Biliary stenting has evolved dramatically over the past 30 years. Advancements in stent design have led to prolonged patency and improved efficacy. However, biliary stenting is still affected by occlusion, migration, anatomical difficulties, and the need for repeat procedures. Multiple novel plastic biliary stent designs have recently been introduced with the primary goals of reduced migration and improved ease of placement. Self-expandable bioabsorbable stents are currently being investigated in animal models. Although not US Food and Drug Administration approved for benign disease, fully covered self-expandable metal stents are increasingly being used in a variety of benign biliary conditions. In malignant disease, developments are being made to improve ease of placement and stent patency for both hilar and distal biliary strictures. The purpose of this review is to describe recent developments and future directions of biliary stenting.

• benign biliary strictures
• bioabsorbable stents
• drug eluting stents
• malignant biliary strictures
• plastic stents
• self-expandable metal stents