ASGE Guideline on the Role of Endoscopy in the Malignant Hilar Obstruction-Webinar Recording

Video Transcription

Video Summary

The video is a webinar presented by the American Society for Gastrointestinal Endoscopy (ASGE) on the ASGE Guideline on the Role of Endoscopy in the Management of Malignant Hyarlobstruction. The webinar is led by Lauren Loading, Manager of Evidence-Based Guidelines and Documents at ASGE, and Dr. Laith Jameel, Section Head of Gastroenterology and Hepatology at Beaumont Health, and features a presentation by Dr. Bashar Qumseh, Associate Professor and Associate Chief of Endoscopy at the University of Florida. <br /><br />The webinar discusses the recommendations of the ASGE guideline on the use of self-expandable metal stents (SEMS) or plastic stents for palliative endoscopic drainage in patients with malignant hyarlobstruction. The guideline recommends SEMS for patients with a short life expectancy or those who prefer to avoid repeated interventions, and plastic stents for patients with an unclear diagnosis or when the optimal drainage strategy is not established. The webinar also addresses the use of bilateral stenting for hyarlobstruction and recommends it over unilateral stenting based on evidence of improved survival and stent patency. In addition, the webinar recommends against routine use of percutaneous biliary drainage as first-line therapy compared to endoscopic drainage in perioperative patients with hyarlobstruction. The webinar highlights the impact of percutaneous drainage on peritoneal metastases and the higher rates of post-procedural mortality and provides general recommendations for managing patients with hyarlobstruction. The video concludes with a Q&A session and a discussion of practical considerations and expert opinions on the management of this condition.

Keywords

ASGE Guideline

Endoscopy

Malignant Hyarlobstruction

Self-expandable metal stents

Plastic stents

Bilateral stenting

Percutaneous biliary drainage

Peritoneal metastases

Patient management