Personalized endoscopy in complex malignant hilar biliary strictures

Andrea Tringali, Pietro Familiari, Vincenzo Perri, Guido Costamagna, Ivo Boskoski, Tommaso Schepis, Vincenzo Bove, Fabia Attili, Rosario Landi

Research output: Contribution to journalArticle

Abstract

Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today a poor prognosis. Endoscopy plays a crucial role in malignant HBO from the diagnosis to the palliation. This technique allows the collection of cytological or histological samples, direct visualization of the suspect malignant tissue, and an echoendoscopic evaluation of the primary tumor and its locoregional staging. Because obstructive jaundice is the most common clinical presentation of malignant HBO, endoscopic biliary drainage, when indicated, is the preferred treatment over the percutaneous approach. Several endoscopic techniques are today available for both the diagnosis and the treatment of biliary obstruction. The choice among them can differ for each clinical scenario. In fact, a personalized endoscopic approach is mandatory in order to perform the proper procedure in the singular patient.
Original languageEnglish
Pages (from-to)1-21
Number of pages21
JournalJournal of Personalized Medicine
Volume11
DOIs
Publication statusPublished - 2021

Keywords

  • Confocal laser endomicroscopy
  • Endoscopic retrograde cholangiopancreatography
  • Endoscopic ultrasound
  • Malignant hilar strictures
  • Peroral cholangioscopy
  • Personalized endoscopy
  • Plastic biliary stents
  • Self-expandable metal stents

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