Stenting in Malignant Biliary Obstruction - 01/10/15

Doi : 10.1016/j.giec.2015.06.002

Majid A. Almadi, MBBS, FRCPC, MSc (Clinical Epidemiology) ^a,^b, Jeffrey S. Barkun, MD, CM, FRCS, MSc ^c, Alan N. Barkun, MD, CM, FRCPC, MSc (Clinical Epidemiology) ^b,^d,^⁎
^a Division of Gastroenterology, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh 11461, Saudi Arabia
^b Division of Gastroenterology, The McGill University Health Center, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montréal, Quebec H3G 1A4, Canada
^c Division of General Surgery, The McGill University Health Centre, McGill University, 1650 Cedar Avenue, Montréal, Quebec H3G 1A4, Canada
^d Division of Clinical Epidemiology, The McGill University Health Center, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montréal, Quebec H3G 1A4, Canada

^∗Corresponding author. Montreal General Hospital, 1650 Cedar Avenue, #D7-148, Montréal, Quebec H3G 1A4, Canada.

Résumé

Decompression of the biliary system in patients with malignant biliary obstruction has been widely accepted and implemented as part of the care. Despite a wealth of literature, there remains a significant amount of uncertainty as to which approach would be most appropriate in different clinical settings. This review covers stenting of the biliary system in cases of resectable or palliative malignant biliary obstruction, potential candidates for biliary drainage, technical aspects of the procedure, as well as management of biliary stent dysfunction. Furthermore, periprocedural considerations including proper mapping of the location of obstruction and the use of antibiotics are addressed.

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Keywords : Malignant, Stents, Bile duct malignancy, Pancreas malignancy, Gallbladder malignancy, Jaundice, Palliative care