Are ERCP intestinal stents covered or uncovered?

ERCP intestinal stents can be either covered or uncovered, and the choice depends on the underlying condition, especially whether the obstruction is malignant or benign.

Uncovered Stents

• Description: Made entirely of metal (usually nitinol or stainless steel) without any coating.

• Use Case:

• Malignant obstructions, such as bile duct or duodenal compression by tumors.

• Advantages:

• Less risk of migration (tumor tissue grows into the stent and anchors it).

• Longer-term patency in fixed malignant lesions.

• Disadvantages:

• Not removable — tissue ingrowth makes extraction difficult or impossible.

• Higher risk of reocclusion due to tumor ingrowth.

Covered Stents

• Description: Metal mesh coated with a non-permeable layer (e.g., PTFE or silicone).

• Use Case:

• Benign strictures, tumors prone to overgrowth, or temporary use where removability is needed.

• Advantages:

• Prevents tumor ingrowth → reduces chance of occlusion.

• Removable, which is helpful in benign disease.

• Disadvantages:

• Higher risk of migration, especially in mobile areas like the duodenum.

• Can block side branches like cystic or pancreatic ducts (→ risk of cholecystitis or pancreatitis).

Summary Table

Most malignant strictures are treated with metal stents, and the choice between covered or uncovered depends on the need for removability, risk of ingrowth, and location.

Would you like to see which type is preferred for a specific condition like pancreatic cancer or benign biliary stricture?