| Theme |
Hilar and Intrahepatic Cholangiocarcinoma |
| Title |
Preoperative Biliary Drainage and Permanent Stenting for Hilar Cholangiocarcinoma |
| Author |
Hirofumi Kogure |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Hiroyuki Isayama |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Takashi Sasaki |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Natsuyo Yamamoto |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Kenji Hirano |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Naoki Sasahira |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Minoru Tada |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author |
Kazuhiko Koike |
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] |
Most patients with hilar cholangiocarcinoma suffer from obstructive jaundice. Therefore, biliary drainage has an important role to play in both resectable and unresectable cases. It also affects the patientʼs prognosis and QOL. Preoperative biliary drainage isperformed only for liver lobes which will remain after resection. Endoscopic drainage is now considered preferable to percutaneousdrainage. Strategies for permanent stentitng for unresectable hilar cholangiocarcinoma have not yet been standardized. There is still controversy concerning approach route, stent type, and drainage area. New metallic stents, such as the Niti-S Y-type stent and the Niti-S large cell D-type stent (LCD), have recently been developed for bilateral stent-in-stent proceduresto facilitate contralateral stent deployment through the interstices of the first metallic stent. The newly designed stents exhibit high technical success rates, low stent-related complications, and good stent patency. Endoscopic reinterventions for occluded stents may be performed easily, particularly in patients with bilateral LCD placement. LCDs may be feasible and effective for both uni and bilateral biliary drainage in patientswith unresectable hilar cholangiocarcinoma. |