Clin Endosc.  2014 Sep;47(5):440-446. 10.5946/ce.2014.47.5.440.

Bilateral Metallic Stenting in Malignant Hilar Obstruction

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@schmc.ac.kr

Abstract

Endoscopic palliative biliary drainage is considered as a gold standard treatment in advanced or inoperable hilar cholangiocarcinoma. Also, metal stents are preferred over plastic stents in patients with >3 months life expectancy. However, the endoscopic intervention of advanced hilar obstruction is often more challenging and complex than that of distal malignant biliary obstructions. In this literature review, we describe the issues commonly encountered during endoscopic unilateral (single) versus bilateral (multiple) biliary stenting for malignant hilar obstruction. Also, we provide technical guidance to improve the technical success rates and patient outcomes, focusing on bilateral metallic stenting techniques such as stent-in-stent or side-by-side deployment.

Keyword

Hilar cholangiocarcinoma; Metal stents; Bilateral drainage

MeSH Terms

Cholangiocarcinoma
Drainage
Humans
Life Expectancy
Plastics
Stents*
Plastics
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