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Updated: May 22, 2026
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Covered metallic stent for ischemic hilar biliary stricture
Hiroshi Kawakami1, Masaki Kuwatani, Kazunori Eto
1Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. hiropon@med.hokudai.ac.jp
Summary
Endoscopic treatment for hilar benign bile duct stricture (BDS) is effective. Fully-covered self-expandable metallic stents (SEMS) offer a feasible approach for managing complex BDS cases, improving long-term outcomes.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Endoscopy
Background:
- Hilar benign bile duct strictures (BDS) pose treatment challenges.
- Conventional single biliary stent placement offers poor long-term outcomes.
- Endoscopic biliary drainage is preferred over surgery but requires optimized techniques.
Observation:
- Multiple stenting is challenging in BDS.
- Stenting above the papilla and fully-covered self-expandable metallic stents (SEMS) are alternative endoscopic approaches.
- Individualized treatment strategies are crucial for hilar benign BDS.
Findings:
- Fully-covered SEMS provide a feasible option for hilar benign BDS.
- This approach may offer improved outcomes compared to conventional methods.
- Successful placement of fully-covered SEMS was reported for post-hepatectomy hilar benign BDS.
Implications:
- Fully-covered SEMS represent a promising endoscopic solution for complex hilar benign BDS.
- Further research is warranted to establish optimal endoscopic strategies.
- Personalized endoscopic management can improve patient outcomes for hilar benign BDS.
