Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2016; 8(6): 498-508
Published online Jun 15, 2016. doi: 10.4251/wjgo.v8.i6.498
Malignant biliary obstruction: From palliation to treatment
Brian R Boulay, Aleksandr Birg
Brian R Boulay, Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, United States
Aleksandr Birg, Department of Medicine, University of Illinois Hospital and Health Sciences System, Chicago, IL 60612, United States
Author contributions: All authors equally contributed to this paper with conception of the topic, literature review and analysis, drafting, critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest or financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Brian R Boulay, MD, MPH, Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois Hospital and Health Sciences System, 840 S Wood Street, MC 716, Chicago, IL 60612, United States. bboulay@uic.edu
Telephone: +1-312-4131999 Fax: +1-312-4133798
Received: July 17, 2015
Peer-review started: July 19, 2015
First decision: September 17, 2015
Revised: March 14, 2016
Accepted: April 21, 2016
Article in press: April 23, 2016
Published online: June 15, 2016
Core Tip

Core tip: Treatment of malignant biliary obstruction from cholangiocarcinoma or pancreatic cancer can be performed via endoscopic, percutaneous, or surgical means. The decision of when or how to achieve biliary decompression depends on the patient’s condition, location of stricture, and stage of malignancy. Not all patients require biliary decompression, particularly with resectable tumors. Self-expanding metallic stents or plastic stents may be used for distal malignancy, depending on stage and prognosis. Stents, nasobiliary drainage, or percutaneous drains may be used for hilar strictures. Endoscopic catheter-based therapies such as photodynamic therapy or radiofrequency ablation may prolong patient survival by achieving local tumor control.