11.5-Fr Large-Bore Plastic Stents Versus Fully Covered Self-Expandable Metallic Stents for the Management of Preoperative Endoscopic Biliary Obstruction in Pancreatic Cancer: A Multicenter Retrospective Cohort Study

BACKGROUND: Self-expandable metallic stents (SEMSs) are recommended for preoperative biliary drainage in patients with pancreatic cancer. However, they are associated with a relatively high incidence of non-recurrent biliary obstruction (RBO) adverse events (AEs), such as pancreatitis and cholecystitis. The 11.5-Fr large-bore plastic stent (LBPS) is a newly developed stent with a larger diameter than conventional plastic stents. The aim of the present study was to compare the clinical outcomes of LBPS and SEMS in preoperative biliary drainage for pancreatic cancer. METHODS: We retrospectively evaluated 80 patients who underwent preoperative biliary drainage for pancreatic cancer between January 2011 and December 2025. Patients were divided into the LBPS and SEMS groups according to the stent placed. RESULTS: RBO occurred in 20.0% and 25.0% of patients in the LBPS and SEMS groups, respectively, with no significant difference in the time to RBO between the groups. Pancreatitis and cholecystitis were observed in 0% versus 18.3%, and 0% versus 8.3% of patients in the LBPS and SEMS groups, respectively. CONCLUSION: The 11.5-Fr LBPS demonstrated patency comparable to that of SEMS and was associated with a low incidence of non-RBO AEs. These findings should be interpreted cautiously and require confirmation in larger prospective studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s10620-026-10136-z.