Self-expandable metal stents in malignant biliary obstruction: Back to the roots with uncovered stents as the “new” standard?

Biliary obstruction can arise from different types of malignant disease, including pancreatic cancer, intrinsic cholangiocarcinoma, gallbladder cancer, and metastatic disease. The most common cause of malignant distal biliary obstruction is pancreatic cancer; jaundice will develop in 70% to 90% of patients during the course of their disease. Pancreatic cancer is usually advanced at presentation, and curative intended resection is possible in less than 15% of patients.1 In the United States the incidence of pancreatic cancer is calculated at 12.5 per 100,000 women and men per year according to the SEERS database (National Cancer Institute, Surveillance, Epidemiology, and End Result Program, 2010-2014).

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