title: Endoscopic approach to malignant strictures at the hepatic hilum.
abstract: Hilar tumors have proven to be a challenge to treat and manage because of their poor sensitivity to conventional therapies and our inability to prevent or to detect early tumor formation. Endoscopic stent drainage has been proposed as an alternative to biliary-enteric bypass surgery and percutaneous drainage to palliate malignant biliary obstruction. Prosthetic palliation of patients with malignant hilar stenoses poses particular difficulties, especially in advanced lesions (type II lesions or higher). The risk of cholangitis after contrast injection into the biliary tree in cases where incomplete drainage is achieved is well known. The success rate of plastic stent insertion is around 80% in patients with proximal tumors. Relief of symptoms can be achieved in nearly all patients successfully stented.
authors: Giovanni D
authors: GD
authors: De Palma
authors: Stefania
authors: S
authors: Masone
authors: Maria
authors: M
authors: Rega
authors: Immacolata
authors: I
authors: Simeoli
authors: Francesca
authors: F
authors: Salvatori
authors: Saverio
authors: S
authors: Siciliano
authors: Francesco
authors: F
authors: Maione
authors: Valerio
authors: V
authors: Girardi
authors: Marta
authors: M
authors: Celiento
authors: Giovanni
authors: G
authors: Persico
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D002761:Cholangitis / Q000209:etiology; D004322:Drainage / Q000009:adverse effects; D004724:Endoscopy / Q000379:methods*; D006500:Hepatic Duct, Common / Q000473:pathology / Q000601:surgery*; D006801:Humans; D012307:Risk Factors; D015607:Stents
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