title: Endoscopic management of malignant bile duct strictures.
abstract: Malignant biliary obstruction can arise from intrahepatic, extrahepatic, and hilar locations from either primary or metastatic disease. Biliary-enteric surgical bypass has been surpassed in the last 20 years by endoscopic balloon dilation and stenting. The goal of stenting for biliary decompression is to palliate obstructive symptoms; it has not been shown that survival is affected by stenting alone. Novel endoscopic therapies, including photodynamic therapy and radiofrequency ablation, have been evaluated and show promise. Both therapies seem to be safe and effective in the treatment of malignant bile duct strictures but are in need of prospective studies of longer duration.
authors.affiliation: Division of Gastroenterology, University of Washington Medical Center, Seattle, WA 98195, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Webb
authors.forename: Michael
authors.initials: M
authors.lastname: Saunders
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002779:Cholestasis / Q000209:etiology / Q000628:therapy; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004106:Dilatation; D004867:Equipment Design; D006801:Humans; D008670:Metals; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications / Q000628:therapy*; D010778:Photochemotherapy; D010969:Plastics; D015607:Stents / Q000009:adverse effects
chemical_list: D008670:Metals; D010969:Plastics