BILIARY STENTING

概要

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Biliary stenting is a standard and basic procedure for the management of biliary obstruc-tions. For the management of cholangitis with bile duct stone, recent randomized study showed similar results of plastic stent and naso-biliary drainage tube. Then, the kind of drainage tube was selected by own discretion of each endoscopist or institution. On the other hand, for the management of unresectable biliary malignancies, there were some evidences. For the manage-ment of distal biliary obstruction, uncovered metallic stent showed significantly longer patency than plastic stent. In addition, covered metallic stent was superior to uncovered one according to the randomized study. In Japan, covered metallic stent was selected firstly for the distally obstructed cases. However, for the hilar malignancies, there were few evidences. The controversially points were approach route (endoscopic or percutaneous), type of stent (plastic stent or metallic stent) and drainage area (unilateral or bilateral). The patients with unresecta-ble malignant biliary obstruction acquired low invasive procedure, low rate of complication and long patency for the preservation of patients QOL. Therefore, we have to confirm the way of stenting for the hilar malignancy cases.
社団法人日本消化器内視鏡学会の論文