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. 2024 Sep 16;12(9):E1065–E1074. doi: 10.1055/a-2366-7302

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The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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Fig. 1 — Conceptualized roles of endoscopy in management of malignant hilar biliary obstruction. ERCP; endoscopic retrograde cholangiopancreatography, EUS-BD; endoscopic ultrasound-guided biliary drainage, EUS-GBD; endoscopic ultrasound-guided gallbladder drainage, MDCT; multidetector computed tomography, MRCP; magnetic resonance cholangiopancreatography, PTBD; percutaneous biliary drainage, PTC; percutaneous cholecystostomy, RBO; recurrent biliary obstruction, SEMS; self-expandable metal stent. * Preoperative biliary drainage may be indicated in patients with cholangitis, prolonged jaundice, delayed surgery (e.g. waiting for portal vein intervention, malnutrition [serum albumin less than 3 g/dL], etc.), or total bilirubin ≥15 mg/dL ** Wire-guided selection of preselected liver segment before performing cholangiogram. Followed by air/carbon dioxide cholangiogram or limited injection with contrast media. Photodynamic therapy or endo-biliary radiofrequency ablation may be used as adjunctive treatment before stenting.