Optimizing palliation of malignant hilar strictures by the use of endobiliary stents

The majority of patients with cholangiocarcinoma (CCA) present with obstruction of the extrahepatic biliary tree, resulting in adverse events such as jaundice and cholangitis, which have an impact on overall survival.1 Obstruction of the hepatic confluence from hilar CCA is particularly challenging because the tumor progressively sequesters individual biliary and vascular segments of the liver. Achieving technical success and durable palliation of hilar strictures represents a daunting task that requires a multidisciplinary team of surgeons, oncologists, radiologists, and gastroenterologists.

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