Endoscopic approach to malignant strictures at the hepatic hilum

作     者：Giovanni D De Palma Stefania Masone Maria Rega Immacolata Simeoli Francesca Salvatori Saverio Siciliano Francesco Maione Valerio Girardi Marta Celiento Giovanni Persico 

作者机构：Department of General Surgery Oncologic Surgery and Advanced Technologies Center for Technological Innovation in Surgery (ITC) University of Naples Federico Ⅱ School of Medicine Naples Italy 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2007年第13卷第30期

页      面：4042-4045页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Malignant biliary stenoses Endoscopic retrograde cholangiopancreatography Endoscopic prostheses 

摘      要：Hilar tumors have proven to be a challenge to treat and manage because of their poor sensitivity to conventional therapies and our inability to prevent or to detect early tumor formation. Endoscopic stent drainage has been proposed as an alternative to biliary-enteric bypass surgery and percutaneous drainage to palliate malignant biliary obstruction. Prosthetic palliation of patients with malignant hilar stenoses poses particular difficulties, especially in advanced lesions （type Ⅱ lesions or higher）. The risk of cholangitis after contrast injection into the biliary tree in cases where incomplete drainage is achieved is well known. The success rate of plastic stent insertion is around 80% in patients with proximal tumors. Relief of symptoms can be achieved in nearly all patients successfully stented.