Endoscopic management of malignant biliary obstructions

Cecilia Binda; Margherita Trebbi; Chiara Coluccio; Paolo Giuffrida; Barbara Perini; Giulia Gibiino; Stefano Fabbri; Elisa Liverani; Carlo Fabbri

Authors Cecilia Binda, Margherita Trebbi, Chiara Coluccio, Paolo Giuffrida, Barbara Perini, Giulia Gibiino, Stefano Fabbri, Elisa Liverani, Carlo Fabbri.

Abstract

Malignant biliary obstruction (MBO), both distal and hilar, represents an ensemble of different clinical conditions frequently encountered in everyday practice. Given the frequent unresectability of the disease at presentation and the increasing indications for neoadjuvant chemotherapy, endoscopic biliary drainage is generally required during the course of the disease. With the widespread use of interventional endoscopic ultrasound (EUS) and the introduction of dedicated devices, EUS-guided biliary drainage has rapidly gained acceptance, together with transpapillary endoscopic biliary drainage and the percutaneous approach. This comprehensive review describes
the current role of endoscopy for distal and hilar MBO supported by evidence, with a focus on the current hot topics in this field.

Keywords Malignant biliary obstruction, biliary drainage, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound-guided drainage

Ann Gastroenterol 2024; 37 (3): 291-302