Endoscopic Management in Malignant Biliary Strictures: Tips and Tricks

  • Alberto TringaliEmail author


Malignant biliary strictures (MBS) remain a challenging problem for the diagnosis and treatment, and many issues are still unresolved. We divided MBS into distal (DMBO) and proximal-hilar malignant biliary strictures (HMBO), and we discuss the actual gray zone trying to clarify the best endoscopic approach based on available published data and/or expert opinions. The available stenting techniques are analyzed to compare the effectiveness and the long-term outcomes. The advantages of metal multiple stenting over plastic stenting are discussed. The final part is dedicated to intraductal radiofrequency and photodynamic techniques to improve the patency of the stents and to reduce the need of re-stenting in this cluster of patients. Tips & tricks are discussed in the first part.


Cholangiocarcinoma Malignant biliary strictures Metal biliary stenting Plastic biliary stenting Intraductal radiofrequency 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Endoscopy UnitASST Grande Ospedale Metropolitano NiguardaMilanItaly

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