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Digestive Disease Interventions
DOI: 10.1055/s-0044-1801386
Review Article

Malignant Biliary Strictures: Preoperative and Palliative Interventions

Rajeev N. Priyadarshi 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar, India
,
Piyal Nag
2   Department of Radiodiagnosis, Silchar Cancer Center, Silchar, Assam, India
,
Ramesh Kumar 
3   Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India
,
Utpal Anand 
4   Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India
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Abstract

Malignant biliary strictures represent a significant clinical challenge worldwide, with the majority of cases being unresectable at the time of diagnosis, necessitating palliative biliary drainage. In some cases, preoperative drainage is required to optimize surgical outcomes. Biliary drainage can be performed through either endoscopic or percutaneous methods, each tailored to specific clinical scenarios. Endoscopic techniques include endoscopic retrograde cholangiopancreatography, endoscopic nasobiliary drainage, and endoscopic ultrasound-guided biliary drainage, while percutaneous options involve percutaneous transhepatic biliary drainage and biliary stenting. The choice of technique is guided by imaging findings, the clinical condition of the patient, and the expertise of the interventionist to ensure effective drainage and minimize complications. Although endoscopic methods are well-established and extensively studied, the percutaneous approach offers distinct advantages in certain complex cases. This review provides a comprehensive overview of biliary drainage techniques, with a particular focus on the percutaneous approach.

Keywords

malignant biliary strictures - percutaneous transhepatic biliary drainage - palliative biliary interventions


Publication History

Received: 10 June 2024

Accepted: 02 December 2024

Article published online:
06 January 2025

© 2025. Thieme. All rights reserved.

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