RECENT ADVANCES IN ENDOSCOPIC BILIARY DRAINAGE FOR UNRESECTABLE MALIGNANT HILAR BILIARY OBSTRUCTION

Abstract

Malignant hilar biliary obstruction is caused by various diseases. The location and degree of biliary obstruction are different in each case. Endoscopic biliary drainage using stents is the first-line therapy for unresectable biliary obstruction. Uncovered self-expandable metallic stent (SEMS) is widely used because of longer stent patency. Plastic stent and covered SEMS with 6mm diameter have also been recently used. However, there has been no evidence with regard to drainage area (unilateral or bilateral) or deployment for bilateral drainage (side-by-side or stent-in-stent). Plastic stent is commonly used in re-intervention for recurrent biliary obstruction, but SEMS might be another option on the basis of longer stent patency.