Cholangiocarcinoma and malignant bile duct obstruction： Areview of last decades advances in therapeutic endoscopy

• 作者: Angelo Caruso Carmelo Barbera Flavia Pigò Helga Bertani Marzio Frazzoni Mauro Manno Raffaele Manta Rita Conigliaro. Santi Mangiafico Vincenzo Giorgio Mirante
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: CHOLANGIOCARCINOMA MALIGNANT BILE ductobstruction INTERVENTIONAL endoscopy Endoscopictherapy Self-expandable metal STENT
• 年，卷（期）: 2015,（6）
• 页码范围: 582-592
• 页数: 11页
• 分类号: R

摘要

In the last decades many advances have been achievedin endoscopy, in the diagnosis and therapy ofcholangiocarcinoma,however blood test, magneticresonance imaging, computed tomography scan mayfail to detect neoplastic disease at early stage, thus thediagnosis of cholangiocarcinoma is achieved usuallyat unresectable stage. In the last decades the roleof endoscopy has moved from a diagnostic role toan invaluable therapeutic tool for patients affectedby malignant bile duct obstruction. One of the majorissues for cholangiocarcinoma is bile ducts occlusion,leading to jaundice, cholangitis and hepatic failure.Currently, endoscopy has a key role in the work upof cholangiocarcinoma, both in patients amenable tosurgical intervention as well as in those unfit for surgeryor not amenable to immediate surgical curative resectionowing to locally advanced or advanced disease, withpalliative intention. Endoscopy allows successful biliarydrainage and stenting in more than 90% of patientswith malignant bile duct obstruction, and allows rapidreduction of jaundice decreasing the risk of biliary sepsis.When biliary drainage and stenting cannot be achievedwith endoscopy alone, endoscopic ultrasound-guidedbiliary drainage represents an effective alternativemethod affording successful biliary drainage in morethan 80% of cases. The purpose of this review is tofocus on the currently available endoscopic managementoptions in patients with cholangiocarcinoma.