2017 Volume 31 Issue 1 Pages 39-48
Current status of endoscopic biliary drainage for malignant biliary obstruction is reviewed, especially in the drainage methods based on the respectability of the tumor and the site of the obstruction. The most suitable type of drainage is almost agreed in patients with unresectable distal obstruction and resectable hilar obstruction. On the other hand, there is no clear consensus about efficacy of preoperative drainage for resectable distal obstruction. Moreover selection of plastic stent or covered metallic stent remains unresolved. In patients with unresectable hilar obstruction, plastic stent vs metallic stent, unilateral vs bilateral drainage, and appropriate method in bilateral stenting (stent in stent technique vs side by side technique) are issues that are still being discussed. We should perform endoscopic biliary drainage consulting with surgeons in resectable cases, and take account of re-intervention in unresectable cases.
