Specially designed stents for translumenal drainage

Endoscopic ultrasonography (EUS)-guided translumenal drainage of pancreatic fluid collections and obstructed bile and pancreatic ducts has been widely practiced for over a decade now, using conventional tubular plastic and metal stents. Their application for transmural drainage has been “off label” and limited by the lack of lumen-to-lumen anchorage that can lead to leakage, perforation, and stent migration. In addition, the length of a tubular stent exceeding the anatomical requirement of a translumenal anastomosis can lead to tissue trauma at the stent ends. Novel stent designs dedicated to applications of translumenal drainage have recently emerged and promise to make transmural drainage quicker, safer, and more effective. Importantly, passage of an endoscope through a translumenal stent will enable the endoscopist to expand the frontier of endoscopic intervention to structures outside of the gastrointestinal tract.