The Role of Endoscopy in the Management of Cholangiocarcinoma

Cholangiocarcinoma is a complex disease, in most cases unresectable at the diagnosis. The cornerstone of management is biliary drainage. The endoscopic approach, in particular, is the treatment of choice both preoperatively and in the forms that require palliation. It makes use of a wide range of stents: plastic, metal self-expanding, bare, covered. Complicated hilar strictures require appropriate work-up, technical skill, strategy. Photodynamic therapy has proved to offer significant advantages in terms of survival and quality of life and favorable results as neo-adjuvant and adjuvant therapy against a discrete tolerability and fewer side effects than chemotherapy.