Common controversies in management of biliary strictures
| Autor: | Mansour A. Parsi |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Cholangitis Sclerosing Controversy Constriction Pathologic Endoscopic management Biliary drainage Gastroenterology Hilar stricture Primary sclerosing cholangitis 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient Bridge to surgery Preoperative Cholangiopancreatography Endoscopic Retrograde Malignant Heterogeneous group Cholestasis medicine.diagnostic_test business.industry General surgery Treatment options Endoscopy General Medicine medicine.disease Bile Ducts Intrahepatic Editorial Bile Duct Neoplasms Benign 030220 oncology & carcinogenesis Drainage 030211 gastroenterology & hepatology Stents Bile Ducts Biliary stricture business |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 2219-2840 |
| Popis: | Biliary strictures are caused by a heterogeneous group of benign and malignant conditions, each requiring a specific treatment approach. Management of biliary strictures often involves endoscopy either for definite treatment, as a bridge to surgery or for palliative purposes. Endoscopic treatment of various types of biliary strictures is not standardized and there are multiple areas of controversy regarding the best treatment options. These controversies are mainly due to lack of well-designed comparative studies to support a specific therapy. This paper reviews three common areas of controversy in the endoscopic management of biliary strictures. The areas discussed in this editorial include the role of biliary drainage in resectable malignant strictures and whether such drainage should be performed routinely prior to surgery, the best endoscopic palliation for unresectable hilar strictures and whether unilateral or bilateral stenting should be attempted, and the optimal endoscopic management for dominant strictures in patients with primary sclerosing cholangitis. The goal of this editorial is twofold. The first is to review the current literature on management of the aforementioned strictures and offer recommendations based on available evidence. The second goal is to highlight the gaps in our knowledge which in turn can encourage future research on these topics. |
| Databáze: | OpenAIRE |
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