title: Metal stents for hilar lesions.
abstract: Strictures at the hilum are caused by varied conditions and don't usually become symptomatic until obstructing the bile ducts, thus posing diagnostic and therapeutic challenges to physicians. ERCP is the method of choice for tissue diagnosis and decompression. MRCP or MRI with dedicated liver protocol provides a unique ability to visualize anatomy and promote procedure planning. In patients with unresectable tumor, endoscopic biliary stenting is a palliative approach. Percutaneous or EUS-guided approach is reserved for endoscopic failure. Various new modalities such as radiotherapy, chemotherapy and Photodynamic therapy have emerged but their superiority needs to be confirmed with Randomized Control studies.
authors: Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA.
authors: Indu
authors: I
authors: Srinivasan
authors: Michel
authors: M
authors: Kahaleh
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000150:complications*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects / Q000379:methods*; D002779:Cholestasis / Q000628:therapy*; D003251:Constriction, Pathologic / Q000628:therapy; D006500:Hepatic Duct, Common; D006801:Humans; D018285:Klatskin Tumor / Q000150:complications*; D015607:Stents / Q000009:adverse effects