Endoscopic Treatment of Malignant Hilar Biliary Obstruction

Simple Summary Biliary stenting is today the primary method of palliative and bridging treatment in patients with malignant hilar biliary obstructions. Systematization, collection and interpretation of the studies performed so far is necessary to form appropriate recommendations and guidelines for the management, selection of drainage methods, selection of appropriate types of stents, their quantity and possible additional methods of endoscopic treatment.Abstract Stent implantation is an effective approach for palliative treatment of Bismuth-Corlette type III-IV malignant hilar biliary obstructions (MHBOs). In this article, we reviewed the currently used access methods for biliary stent placement (percutaneous transhepatic biliary drainage, endoscopic biliary drainage, endosonography guided biliary drainage), the available stent types (plastic stent, self-expanding metallic stent, full cover self-expanding metallic stent, radioactive self-expanding metallic stent), major approaches (unilateral, bilateral) and deployment methods (stent-in-stent, stent-by-stent). Finally, this review gives an outlook on perspectives of development in stenting and other palliative methods in MHBO.