Malignant Biliary Obstruction: Evidence for Best Practice

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art_PU_Malignant_Biliary_Obstruction_Evidence_for_Best_Practice_2016.PDF (1.23 MB)
Citações na Scopus
50
Tipo de produção
article
Data de publicação
2016
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
HINDAWI PUBLISHING CORP
Autores
SINGH, Rajvinder
LOONG, Cheong Kuan
Citação
GASTROENTEROLOGY RESEARCH AND PRACTICE, article ID 3296801, 7p, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
What should be done next? Is the stricture benign? Is it resectable? Should I place a stent? Which one? These are some of the questions one ponders when dealing with biliary strictures. In resectable cases, ongoing questions remain as to whether the biliary tree should be drained prior to surgery. In palliative cases, the relief of obstruction remains the main goal. Options for palliative therapy include surgical bypass, percutaneous drainage, and stenting or endoscopic stenting (transpapillary or via an endoscopic ultrasound approach). This reviewgathers scientific foundations behind these interventions. For operable cases, preoperative biliary drainage should not be performed unless there is evidence of cholangitis, there is delay in surgical intervention, or intense jaundice is present. For inoperable cases, transpapillary stenting after sphincterotomy is preferable over percutaneous drainage. The use of plastic stents (PS) has no benefit over Self-Expandable Metallic Stents (SEMS). In case transpapillary drainage is not possible, Endoscopic Ultrasonography- (EUS-) guided drainage is still an option over percutaneousmeans. There is no significant difference between the types of SEMS and its indication should be individualized.
Palavras-chave
URI
https://observatorio.fm.usp.br/handle/OPI/14490
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35