title: Expandable metal stents for malignant hilar biliary obstruction.
abstract: Most patients with malignant hilar stenoses are candidates for palliation. For this purpose, biliary drainage plays a major role in improving liver function and managing or avoiding cholangitis. Endoscopic interventions are less invasive than the percutaneous approach and should be considered as the first-line drainage procedures in most cases. Transhepatic interventions should be reserved for endoscopic failures or performed as a complementary approach in a combined procedure. After successful endoscopic access to biliary obstruction, implantation of self-expandable metal stents offers advantages over plastic endoprostheses in terms of stent patency and number of reinterventions.
authors.affiliation: Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Kirchfeldstraße 40, 40217 Duesseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerges
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schumacher
authors.forename: Grischa
authors.initials: G
authors.lastname: Terheggen
authors.forename: Horst
authors.initials: H
authors.lastname: Neuhaus
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications*; D018281:Cholangiocarcinoma / Q000150:complications*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D049448:Cholangiopancreatography, Magnetic Resonance; D002779:Cholestasis / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008670:Metals; D015607:Stents / Q000009:adverse effects
chemical_list: D008670:Metals