Lee Tae Hoon, Moon Jong Ho, Park Sang-Heum
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
Clin Endosc. 2014 Sep;47(5):440-6. doi: 10.5946/ce.2014.47.5.440. Epub 2014 Sep 30.
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.
内镜下姑息性胆道引流被认为是晚期或无法手术切除的肝门部胆管癌的金标准治疗方法。此外，对于预期寿命大于3个月的患者，金属支架优于塑料支架。然而，晚期肝门部梗阻的内镜介入治疗通常比远端恶性胆道梗阻的治疗更具挑战性和复杂性。在这篇文献综述中，我们描述了在恶性肝门部梗阻的内镜单侧（单个）与双侧（多个）胆道支架置入过程中常见的问题。此外，我们提供技术指导以提高技术成功率和患者预后，重点关注双侧金属支架置入技术，如支架套叠或并排置入。
