ERCP Bootcamp for the Endoscopy Team (On-demand) | December 2023-How to Manage a malignant distal biliary stricture diagnosis and drainage

How to Manage a malignant distal biliary stricture diagnosis and drainage

Video Transcription

Video Summary

Dr. Doug Adler gave a lecture on managing malignant distal biliary strictures. He discussed the typical presentation of an elderly patient with weight loss, abdominal pain, jaundice, and elevated CA19-9 levels. He mentioned that 85% of biliary strictures are malignant, with pancreatic cancer being the most common cause. Other causes include cholangiocarcinoma, ampullary cancer, gallbladder cancer, and metastasis. Dr. Adler emphasized the importance of obtaining a tissue diagnosis and performing an ERCP to stent the obstruction. He mentioned the different options for stents, including plastic stents, uncovered metal stents, partially covered metal stents, and fully covered metal stents. The choice of stent depends on the physician's preference, the patient's condition, and other factors such as the presence of a gallbladder and the need for follow-up ERCP. Dr. Adler also mentioned the importance of imaging modalities such as CT scan and EUS, and the need for careful staging and assessment of vascular involvement. Overall, his lecture provided an overview of the management of distal malignant biliary strictures and highlighted the considerations involved in choosing and placing stents.

Asset Subtitle

Douglas G. Adler, MD, FASGE

Keywords

malignant biliary strictures

elderly patient

ERCP

stents

pancreatic cancer

imaging modalities

tissue diagnosis