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10.3390/jpm11020078
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Review

Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures

by
Ivo Boškoski
1,2,*,†,
Tommaso Schepis
1,2,†,
Andrea Tringali
1,2,
Pietro Familiari
1,
Vincenzo Bove
1,
Fabia Attili
1,
Rosario Landi
1,
Vincenzo Perri
1 and
Guido Costamagna
1,2
1
Center for Endoscopic Research Therapeutics and training (CERTT), Università Cattolica del Sacro Cuore, 20123 Rome, Italy
2
Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
†
Co-first authorship.
J. Pers. Med. 2021, 11(2), 78; https://doi.org/10.3390/jpm11020078
Submission received: 31 December 2020 / Revised: 25 January 2021 / Accepted: 26 January 2021 / Published: 29 January 2021
(This article belongs to the Special Issue Personalized Medicine and Multidisciplinary Approach in Biliopancreatic Endoscopy)
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Abstract

Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today a poor prognosis. Endoscopy plays a crucial role in malignant HBO from the diagnosis to the palliation. This technique allows the collection of cytological or histological samples, direct visualization of the suspect malignant tissue, and an echoendoscopic evaluation of the primary tumor and its locoregional staging. Because obstructive jaundice is the most common clinical presentation of malignant HBO, endoscopic biliary drainage, when indicated, is the preferred treatment over the percutaneous approach. Several endoscopic techniques are today available for both the diagnosis and the treatment of biliary obstruction. The choice among them can differ for each clinical scenario. In fact, a personalized endoscopic approach is mandatory in order to perform the proper procedure in the singular patient.
Keywords: personalized endoscopy; malignant hilar strictures; self-expandable metal stents; plastic biliary stents; endoscopic retrograde cholangiopancreatography; peroral cholangioscopy; confocal laser endomicroscopy; endoscopic ultrasound personalized endoscopy; malignant hilar strictures; self-expandable metal stents; plastic biliary stents; endoscopic retrograde cholangiopancreatography; peroral cholangioscopy; confocal laser endomicroscopy; endoscopic ultrasound

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MDPI and ACS Style

Boškoski, I.; Schepis, T.; Tringali, A.; Familiari, P.; Bove, V.; Attili, F.; Landi, R.; Perri, V.; Costamagna, G. Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures. J. Pers. Med. 2021, 11, 78. https://doi.org/10.3390/jpm11020078

AMA Style

Boškoski I, Schepis T, Tringali A, Familiari P, Bove V, Attili F, Landi R, Perri V, Costamagna G. Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures. Journal of Personalized Medicine. 2021; 11(2):78. https://doi.org/10.3390/jpm11020078

Chicago/Turabian Style

Boškoski, Ivo, Tommaso Schepis, Andrea Tringali, Pietro Familiari, Vincenzo Bove, Fabia Attili, Rosario Landi, Vincenzo Perri, and Guido Costamagna. 2021. "Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures" Journal of Personalized Medicine 11, no. 2: 78. https://doi.org/10.3390/jpm11020078

APA Style

Boškoski, I., Schepis, T., Tringali, A., Familiari, P., Bove, V., Attili, F., Landi, R., Perri, V., & Costamagna, G. (2021). Personalized Endoscopy in Complex Malignant Hilar Biliary Strictures. Journal of Personalized Medicine, 11(2), 78. https://doi.org/10.3390/jpm11020078

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