ASGE Postgraduate Course at ACG: Innovative Practices for the Endoscopist of Today, Tomorrow and Beyond | October 2023-Management of Hilar Obstruction

Video Transcription

Video Summary

In this video lecture, three speakers discuss the approach to hyaluronic acid obstruction and emerging endoscopic techniques and devices being used for this condition. They review the anatomy and approach to hyaluronic acid obstruction, primarily focusing on malignant obstructions. Diagnostic criteria for hyaluronic acid obstruction are discussed, including the appearance of a malignant stricture on imaging and positive biopsy or cytology for malignancy. The speakers emphasize the importance of a multidisciplinary consensus for the approach to malignant hyaluronic acid obstruction, involving surgeons, radiologists, pathologists, and oncologists. They discuss the goals of the approach, such as determining resectability, evaluating the extent of disease, and assessing the relationship to vascular structures and lymph nodes. The case of a 72-year-old male with a history of alcohol use disorder and hypertension, presenting with painless jaundice, is presented as an example. The speakers discuss the management of this patient and highlight controversies in treatment approaches for hyaluronic acid obstruction. They also discuss the use of radiofrequency ablation in cholangiocarcinoma, with the potential to improve stent patency and overall survival. However, more standardized treatment protocols for radiofrequency ablation need to be studied.

Asset Subtitle

Andrew C. Storm, MD (presenter), Joanna Law, MD, FASGE (Panel), Swati Pawa, MD, FASGE (Panel)

Keywords

hyaluronic acid obstruction

endoscopic techniques

malignant obstructions

diagnostic criteria

multidisciplinary consensus

radiofrequency ablation

cholangiocarcinoma