A Review of Direct Endobiliary Techniques for the Management of Biliary Conditions

A majority of patients with cholangiocarcinoma and malignant biliary obstruction cannot undergo surgery for treatment as they present late in the disease course. It is crucial to relieve biliary obstruction in these conditions, for which metallic stents are commonly used. However, these stents have a high rate of occlusion due to the ingrowth of malignant tissue. In this review, we will discuss the use of direct endobiliary therapies that can be used either independently or in combination with metallic stents.