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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 10, 2016; 8(1): 23-29
Published online Jan 10, 2016. doi: 10.4253/wjge.v8.i1.23
Role of self-expanding metal stents in the management of variceal haemorrhage: Hype or hope?
Brian J Hogan, James P O’Beirne
Brian J Hogan, James P O’Beirne, Institute for Liver and Digestive Health, UCL, Royal Free Hospital, London NW3 2QG, United Kingdom
James P O’Beirne, the Sheila Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Royal Free Hospital, London NW3 2QG, United Kingdom
Author contributions: Both authors contributed to this paper.
Conflict-of-interest statement: Brian J Hogan and James P O’Beirne are co-investigators in a multi-centre randomized controlled trial of self-expanding metal stents in the management of variceal haemorrhage. The “Stent Oesophageal Varices” trial has received financial support from Ella CS.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. James P O’Beirne, Consultant Hepatologist, the Shelia Sherlock Liver Centre, Royal Free London NHS Foundation Trust, Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom. james.o’beirne@nhs.net
Telephone: +44-20-77940500-33998 Fax: +44-20-74726226
Received: June 29, 2015
Peer-review started: July 2, 2015
First decision: August 4, 2015
Revised: October 8, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: January 10, 2016
Core Tip

Core tip: Failure to control bleeding in high-risk patients with variceal haemorrhage is still common, and not all patients are suitable for transjugular intrahepatic portosystemic shunts. Self-expanding metal stents can be placed without the need for endoscopic or fluoroscopic control and, once in place, provide effective haemostasis and allow a route for oral fluids and nutrition. They can remain in place whilst liver function recovers and secondary prophylaxis is initiated or whilst definitive therapy is provided. Self-expanding metal stents provide effective haemostasis and perform better than balloon tamponade in refractory bleeding, where they are associated with fewer complications.