Malignant biliary obstruction: From palliation to treatment

Figure 1 Algorithm for treatment of distal malignant biliary obstruction based on disease stage. Patients who are not candidates for ERCP with stent placement may undergo EUS-BD or percutaneous drainage. Adapted from Boulay BR, Parepally M. World J Gastroenterol 2014; 20: 9345-9353. SEMS: Self-expanding metallic stent; ERCP: Endoscopic retrograde cholangiography; EUS-BD: Endoscopic ultrasound-guided biliary drainage.

Figure 2 Algorithm for treatment of hilar malignant biliary obstruction. PBD is an individualized decision based on local expertise. PTBD: Percutaneous transhepatic biliary drainage; SEMS: Self-expanding metallic stent; PBD: Preoperative biliary drainage.