Evidence-Based Decompression in Malignant Biliary Obstruction.
10.3348/kjr.2012.13.S1.S56
- Author:
Chia Sing HO
1
;
Andrew E WARKENTIN
Author Information
1. Department of Medical Imaging, University of Toronto, Toronto General Hospital, 585 University Ave, Toronto, ON, M5G 2N2 Canada. Chia.ho@uhn.on.ca
- Publication Type:Review
- Keywords:
Malignant biliary obstruction;
Percutaneous, endoscopic, biliary drainage;
Evidence-based medicine;
Cholangiocarcinoma, Klatskin tumor
- MeSH:
Bile Duct Neoplasms/pathology/surgery;
Biliary Tract Diseases/pathology/*surgery;
Cholangiocarcinoma/pathology/surgery;
Decompression, Surgical;
Drainage/methods;
Endoscopy;
*Evidence-Based Medicine;
Hepatic Duct, Common;
Humans;
Jaundice, Obstructive/pathology/*surgery;
Klatskin's Tumor/pathology/surgery;
Stents
- From:Korean Journal of Radiology
2012;13(Suppl 1):S56-S61
- CountryRepublic of Korea
- Language:English
-
Abstract:
As recent advances in chemotherapy and surgical treatment have improved outcomes in patients with biliary cancers, the search for an optimal strategy for relief of their obstructive jaundice has become even more important. Without satisfactory relief of biliary obstruction, many patients would be ineligible for treatment. We review all prospective randomized trials and recent retrospective non-randomized studies for evidence that would support such a strategy. For distal malignant biliary obstruction, an optimal strategy would be insertion of metallic stents either endoscopically or percutaneously. Evidence shows that a metallic stent inserted percutaneously has better outcomes than plastic stents inserted endoscopically. For malignant hilar obstruction, percutaneous biliary drainage with or without metallic stents is preferred.
