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Technical tips and troubleshooting of endoscopic biliary drainage for unresectable malignant hilar biliary obstruction

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Title: Technical tips and troubleshooting of endoscopic biliary drainage for unresectable malignant hilar biliary obstruction
Authors: Kawakami, Hiroshi Browse this author →KAKEN DB
Itoi, Takao Browse this author →KAKEN DB
Kuwatani, Masaki Browse this author →KAKEN DB
Kawakubo, Kazumichi Browse this author
Kubota, Yoshimasa Browse this author
Sakamoto, Naoya Browse this author →KAKEN DB
Keywords: Biliary drainage
Hilar biliary obstruction
Issue Date: Apr-2015
Publisher: Wiley
Journal Title: Journal of hepato-biliary-pancreatic sciences
Volume: 22
Issue: 4
Start Page: E12
End Page: E21
Publisher DOI: 10.1002/jhbp.186
PMID: 25379788
Abstract: 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 nonsurgical, 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.
Rights: This is the peer reviewed version of the following article: Kawakami, H., Itoi, T., Kuwatani, M., Kawakubo, K., Kubota, Y. and Sakamoto, N. (2015), Technical tips and troubleshooting of endoscopic biliary drainage for unresectable malignant hilar biliary obstruction, J Hepatobiliary Pancreat Sci, 22, E12–E21, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 河上 洋

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