Role of ERCP in Malignant Hilar Biliary Obstruction
- Abstract
- Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment method for biliary malignancies. However, most of the patients with MHO cannot undergo surgeries on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and quality of life. Among drainage methods, endoscopic biliary drainage is the current standard for the palliation of unresectable advanced MHO. The development of stents and various accessories and advances in endoscopic techniques including endoscopic ultrasonography have facilitated primary endoscopic intervention in difficult high-grade hilar strictures. However, some issues are still under debate, such as palliation methods, appropriate stents, the number of stents, deployment methods, and additional local ablation therapies. Therefore, this review presents currently optimal endoscopic palliation methods for advanced MHO based on the reported literature.
- All Author(s)
- T. H. Lee
; J. H. Moon
; S. Stuart
- Issued Date
- 2022
- Type
- Article
- Keyword
- *Bile Duct Neoplasms/complications; Bile Ducts, Intrahepatic/surgery; *Cholangiocarcinoma; Cholangiopancreatography, Endoscopic Retrograde/adverse effects; *Cholestasis/etiology/surgery; Drainage/methods; Humans; Palliative Care/methods; Quality of Life; Stents/adverse effects; Treatment Outcome; Drainage; Endoscopy; Malignant Hilar Obstruction
- ISSN
- 1052-5157
- Citation Title
- Gastrointestinal Endoscopy Clinics of North America
- Citation Volume
- 32
- Citation Number
- 3
- Citation Start Page
- 427
- Citation End Page
- 453
- Language(ISO)
- eng
- DOI
- 10.1016/j.giec.2022.01.003
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2786
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