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Technical tips and troubleshooting of endoscopic biliary drainage for unresectable malignant hilar biliary obstruction.
[cholangiocarcinoma]
Unresectable
malignant
hilar
biliary
obstruction
(
MHBO
)
occurs
in
various
diseases
,
such
as
cholangiocarcinoma
,
gallbladder
carcinoma
,
hepatocellular
carcinoma
,
pancreatic
cancer
,
and
lymph
node
metastasis
of
the
hilum
of
the
liver
.
The
majority
of
patients
with
advanced
MHBO
are
not
candidates
for
surgical
resection
because
of
the
tumor
location
in
the
hepatic
hilum
and
adjacent
areas
,
advanced
tumor
stage
,
or
comorbidities
.
Therefore
,
these
patients
often
have
a
poor
prognosis
in
terms
of
survival
and
quality
of
life
.
Most
of
these
patients
will
require
non-surgical
,
palliative
biliary
drainage
.
To
date
,
various
biliary
drainage
techniques
for
unresectable
MHBO
(
UMHBO
)
have
been
reported
.
Of
these
techniques
,
endoscopic
biliary
drainage
is
currently
considered
to
be
the
most
safe
and
minimally
invasive
procedure
.
However
,
endoscopic
biliary
drainage
for
UMHBO
is
still
not
standardized
regarding
the
optimal
stent
,
drainage
area
,
stenting
method
,
and
reintervention
technique
.
Recently
,
towards
standardization
of
this
technique
for
UMHBO
,
clinical
research
and
trials
including
randomized
controlled
trials
have
been
performed
.
In
this
article
,
we
reviewed
the
most
important
issues
regarding
endoscopic
biliary
drainage
for
UMHBO
,
focusing
on
prospective
studies
.
We
also
described
in
detail
the
techniques
and
future
perspectives
of
endoscopic
biliary
drainage
in
patients
with
UMHBO
.
Diseases
Validation
Diseases presenting
"endoscopic biliary drainage in patients"
symptom
cholangiocarcinoma
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