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Updated: Jan 6, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

Biliary stenting for hilar malignant biliary obstruction.

Tae Hoon Lee¹, Jong Ho Moon², Sang-Heum Park¹

¹Division of Gastroenterology and Hepatology, Department of Internal Medicine, SoonChunHyang University School of Medicine, Cheonan Hospital, Cheonan, Korea.

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society

|October 4, 2019

Summary

Endoscopic stenting is increasingly successful for malignant biliary obstruction. This review identifies optimal strategies for hilar obstruction, comparing stent types, numbers, and deployment methods.

Keywords:

biliary drainage hilar obstruction stent

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Published on: May 2, 2025

Area of Science:

Gastroenterology
Interventional Endoscopy
Oncology

Background:

Malignant biliary obstruction (MBO) often requires palliation.
Percutaneous approaches were historically favored for complex hilar MBO due to technical challenges.
Recent advances favor endoscopic interventions with improved success and safety.

Purpose of the Study:

To review the literature on endoscopic biliary stenting for hilar MBO.
To identify the optimal stenting strategy regarding stent type, number, and deployment.
To compare endoscopic versus percutaneous approaches for hilar MBO.

Main Methods:

Literature review of studies on biliary stenting for hilar malignant biliary obstruction.
Focus on stent type (plastic vs. metal), stent number (unilateral vs. bilateral), and deployment method (stent-in-stent vs. stent-by-stent).
Analysis of technical success, clinical success, and adverse events.

Main Results:

Endoscopic palliation shows higher technical and clinical success with fewer adverse events than percutaneous approaches.
Advances in metal stents, accessories, and techniques have increased endoscopic intervention frequency.
Optimal stent type, number, and deployment methods for hilar MBO require further clarification.

Conclusions:

Endoscopic stenting is a viable and often preferred option for hilar malignant biliary obstruction.
Further research is needed to define the optimal biliary stenting strategy.
Refining stent selection and deployment techniques can improve patient outcomes.