Inoue Tadahisa, Naitoh Itaru
Department of Gastroenterology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute 480-1195, Aichi, Japan.
Department of Gastroenterology, Nagoya City University Midori Municipal Hospital, 1-77 Shiomigaoka, Midori-ku, Nagoya 458-0037, Aichi, Japan.
J Clin Med. 2024 Sep 12;13(18):5410. doi: 10.3390/jcm13185410.
Malignant hilar biliary obstruction (MHBO) can cause obstructive jaundice and/or cholangitis necessitating appropriate biliary drainage. Endoscopic biliary stenting is the first-choice treatment, especially in unresectable cases, owing to its minimally invasive nature and utility. However, the hilar region is complex because of the branching and curving of bile ducts, making strictures in this area more complicated. Therefore, MHBO stenting is challenging, and treatment strategies have yet to be established. Furthermore, recent advances in antitumor therapies have altered the background surrounding the development of stenting strategies. Therefore, it is necessary to understand and grasp the current evidence well and to accumulate additional evidence reflecting the current situation. This study reviews the current status, issues, and prospects of endoscopic stenting for MHBO, especially in unresectable cases.
恶性肝门部胆管梗阻（MHBO）可导致梗阻性黄疸和/或胆管炎，因此需要进行适当的胆道引流。内镜下胆管支架置入术是首选治疗方法，尤其是在不可切除的病例中，因其具有微创性和实用性。然而，由于胆管的分支和弯曲，肝门区域结构复杂，使得该区域的狭窄更为复杂。因此，MHBO支架置入术具有挑战性，且治疗策略尚未确立。此外，抗肿瘤治疗的最新进展改变了支架置入策略发展的背景。因此，有必要充分理解和掌握当前的证据，并积累反映当前情况的更多证据。本研究回顾了MHBO内镜下支架置入术的现状、问题和前景，尤其是在不可切除病例中的情况。
