Gastrointest Interv 2018; 7(2): 52-56
Usefulness of stent placement above the papilla, so-called, ‘inside stent’
Tanyaporn Chantarojanasiri,1,* Hirofumi Kogure,2 Tsuyoshi Hamada,2 Yousuke Nakai,2 Hiroyuki Isayama3
1Department of Internal Medicine, Police General Hospital, Bangkok, Thailand
2Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
Department of Internal Medicine, Police General Hospital, 492/1 Rama 1 Road, Pathumwan, Bangkok 10330, Thailand.
E-mail address: (T. Chantarojanasiri). ORCID:
Received: April 23, 2018; Accepted: June 19, 2018; Published online: July 31, 2018.
© Society of Gastrointestinal Intervention. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Stent occlusion and cholangitis are common complications after endoscopic biliary stenting caused by duodenobiliary refluxes and food impaction. To prolong the stent patency, the concept of stenting above the papilla, so-called inside stent, has been developed. Various studies of the inside stent in the treatment of both benign and malignant biliary obstruction have been published, with a promising result. However, most studies were retrospective, with wide variation of stent type and the etiology of biliary obstruction. This review aims to summarize the principle, evidence, and the usefulness of inside biliary stent.
Keywords: Cholestasis; Extrahepatic; Stent

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