Management of hilar biliary strictures.

摘要: Biliary strictures at the liver hilum are caused by a heterogeneous group of benign and malignant conditions. In absence clear-cut etiology, i.e. bile duct damage during surgery, hilar biliary remain diagnostic therapeutic challenge for which multidisciplinary approach is often necessary. A definitive diagnosis can be achieved in only 40-60% patients, while all other cases treated as though they until surgical pathology determines otherwise. Surgical resection treatment that prolongs survival patients with strictures. Because these tumors frequently extend longitudinally via hepatic ducts into parenchyma, partial has been gradually added to ensure tumor-free margins. For unresectable cases, endoscopic stenting obstruction considered preferred palliation modality relieve pruritus, cholangitis, pain jaundice, percutaneous reserved failure. Other modalities such radiotherapy, chemotherapy, photodynamic therapy currently investigational. post strictures, repair difficult requires specific skills experience. As an alternative, multi-stent technique placement increasing number stents over time complete resolution stricture proposed.