Advances In Endoscopic Treatment Of Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma is one of the most common causes of malignant biliary obstruction in Asia,in recent years the incidence rate showed a gradual upward trend.Because of its insidious onset,complex anatomical structure,early diagnosis is quite difficult,majority of patients are diagnosed at an advanced stage of disease,lost the opportunity of radical resection and generally can not tolerate surgerical treatment,the prognosis is very poor.And,more than 90% of the patients who with advanced stage of disease were involved in biliary obstruction,often associated with severe biliary tract infection,seriously affect the life quality of patients,and even life-threatening.Therefore,to remove the obstruction and recover bile drainage has become the main target of the treatment of them.Currently,Endoscopic palliative biliary drainage as the preferred treatment of unresectable hilar cholangiocarcinoma on the choice of biliary stent materials,types and the placement of stents in different Bismuth types is still controversial.In recent years,the development of Biliary stents is rapid,many new stents have been developed,and the effects of different stent materials,types and placement quantity,methods for the treatment and prognosis are not the same,furthermore,the complications of endoscopic therapy often affect the biliary drainage effect.So,the endoscopic selection of biliary stent and the placement of different bismuth type and its common complications will be reviewed in this paper,to provide a reference of the endoscopic treatment for clinical unresectable hilar cholangiocarcinoma.