Format

Send to:

Choose Destination
See comment in PubMed Commons below
Clin Endosc. 2013 May;46(3):260-6. doi: 10.5946/ce.2013.46.3.260. Epub 2013 May 31.

Technical tips and issues of biliary stenting, focusing on malignant hilar obstruction.

Author information

  • 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

Abstract

Although there is no survival advantage, inoperable hilar cholangiocarcinoma managed by palliative drainage may benefit from symptomatic improvement. In general, biliary drainage is divided into endoscopic or percutaneous approaches and surgical drainage. Plastic or metal stent is the most preferred device for palliative drainage in endoscopic approach. Considering cost-effectiveness, use of metallic stent is preferred than plastic stents in patients with more than 3 months of life expectancy with inoperable malignant biliary obstruction. In patients with unresectable malignant hilar obstruction, the endoscopic approach with biliary stent placement by experts has been considered as the treatment of choice. However, the endoscopic management of hilar obstruction is often more challenging and complex than distal malignant biliary obstructions. There is still a lack of clear consensus on the use of plastic versus metal stents and unilateral versus bilateral drainage since the decision should be made under many grounds such as the volume of liver drainage more than 50%, life expectancy, and expertise of the facility.

KEYWORDS:

Biliary drainage; Malignant hilar obstruction; Stents

PMID:
23767037
[PubMed]
PMCID:
PMC3678064
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Korean Society of Gastrointestinal Endoscopy Icon for PubMed Central
    Loading ...
    Write to the Help Desk