Palma GDD, Masone S, Rega M, Simeoli I, Salvatori F, Siciliano S, Maione F, Girardi V, Celiento M, Persico G. Endoscopic approach to malignant strictures at the hepatic hilum. World J Gastroenterol 2007; 13(30): 4042-4045 [PMID: 17696220 DOI: 10.3748/wjg.v13.i30.4042]
Corresponding Author of This Article
Professor Giovanni D De Palma, Department of General Surgery, Oncologic Surgery and Advanced Technologies, Center for Technological Innovation in Surgery (ITC), University of Naples Federico II, School of Medicine, Via Panini 5, Naples 80131, Italy. giovanni.depalma@unina.it
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Editorial
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World J Gastroenterol. Aug 14, 2007; 13(30): 4042-4045 Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4042
Endoscopic approach to malignant strictures at the hepatic hilum
Giovanni D De Palma, Stefania Masone, Maria Rega, Immacolata Simeoli, Francesca Salvatori, Saverio Siciliano, Francesco Maione, Valerio Girardi, Marta Celiento, Giovanni Persico
Giovanni D De Palma, Stefania Masone, Maria Rega, Immacolata Simeoli, Francesca Salvatori, Saverio Siciliano, Francesco Maione, Valerio Girardi, Marta Celiento, Giovanni Persico, Department of General Surgery, Oncologic Surgery and Advanced Technologies, Center for Technological Innovation in Surgery (ITC), University of Naples Federico II, School of Medicine, Naples, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Giovanni D De Palma, Department of General Surgery, Oncologic Surgery and Advanced Technologies, Center for Technological Innovation in Surgery (ITC), University of Naples Federico II, School of Medicine, Via Panini 5, Naples 80131, Italy. giovanni.depalma@unina.it
Telephone: +39-81-7462773 Fax: +39-81-7462752
Received: April 20, 2007 Revised: May 1, 2007 Accepted: May 12, 2007 Published online: August 14, 2007
Abstract
Hilar tumors have proven to be a challenge to treat and manage because of their poor sensitivity to conventional therapies and our inability to prevent or to detect early tumor formation. Endoscopic stent drainage has been proposed as an alternative to biliary-enteric bypass surgery and percutaneous drainage to palliate malignant biliary obstruction. Prosthetic palliation of patients with malignant hilar stenoses poses particular difficulties, especially in advanced lesions (type II lesions or higher). The risk of cholangitis after contrast injection into the biliary tree in cases where incomplete drainage is achieved is well known. The success rate of plastic stent insertion is around 80% in patients with proximal tumors. Relief of symptoms can be achieved in nearly all patients successfully stented.
