Treatment of malignant biliary obstruction after initial drainage

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What can be done to manage the treatment of malignant biliary obstruction after initial drainage?

With some tumor types, access to the bile ducts allows for the placement of radioactive isotopes for ductal brachytherapy. If the patient is not a candidate for surgical resection, the drainage catheters may be left in long term. Sometimes, internal metal stents may be placed across malignant strictures to allow for catheter removal for patient comfort. The decision to place a metallic stent depends on patient prognosis and life expectancy because internal metal stents have limited long-term patency (generally about 6 months).

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