Biliary stenting and drainage
A small tube placed by endoscope or through the skin reopens a blocked bile duct, relieving jaundice so chemotherapy can be given.
Most patients with perihilar or distal bile duct cancer present with obstructive jaundice; ERCP-placed plastic or metal stents, or percutaneous transhepatic drainage, are required before systemic therapy (bilirubin must fall) and before surgery in selected cases. Endoscopic ultrasound-guided drainage and radiofrequency ablation of the stricture through the stent are newer adjuncts.
How it works
Restore bile flow across a malignant stricture; self-expanding metal stents stay patent longer than plastic.
- Rapid symptom relief
- Enables chemotherapy dosing
- Cholangitis and stent occlusion
- Pre-operative drainage is debated for resectable disease
Latest papers
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