Malignant biliary disease (2025 – CME) – online course
Description
Authors: T. See & T. Andrasina
Reviewers: F. H. Cornelis, M. Mauda-Havakuk, A. Najafi, T. Pereira & R. Uberoi
This course corresponds to chapter 2.2.5.3.2 Malignant biliary disease in the European Curriculum and Syllabus for Interventional Radiology.
Abstract
Interventional radiology plays an important role in a multidisciplinary approach to malignant biliary obstruction including tissue sampling and palliative treatment of the disease. Transbiliary biopsy and cholangioscopy-guided biopsy enable tissue sampling that is otherwise challenging. Percutaneous external or internal-external biliary drains, and hilar stenting target uni- or bilateral biliary occlusion. Refinement of techniques also facilitates drainage of segmental ducts. Haemorrhage and sepsis are well-recognized complications of the percutaneous approach. Careful patient selection and pre-procedure optimisation are crucial to mitigate these risks. Biliary stents are crucial for managing malignant biliary obstruction, with self-expandable metal stents (SEMS) being the preferred choice. SEMS offer superior patency compared to plastic stents, leading to improved quality of life and reduced healthcare costs. While uncovered SEMS are preferred for hilar strictures, covered SEMS are generally favoured for distal obstructions due to their resistance to tumour ingrowth.
Intraluminal brachytherapy, endoluminal radiofrequency ablation and photodynamic therapy are techniques which complement stenting by further improving patency and potentially prolonging survival.
Learning objectives
- Understand the anatomy and pathophysiology of malignant biliary obstruction
- Learn clinical presentations, diagnosis, and management of options
- Recognize Bismuth classification and its implications for complex hilar occlusion
- Learn transbiliary cholangioscopy navigated biopsy technique
- Learn to conduct risk assessment and optimization of percutaneous biliary drainage
- Get tips and tricks on percutaneous biliary drainage and stenting techniques
- Understand endobiliary radiofrequency ablation
- Become aware of factors relevant to technical and clinical outcomes
Further information
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.5.3.2 Malignant biliary disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 2 European CME credits (ECMEC).
The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.
The enrolment period of this course is linked to the validity of the All-Access Pass.
Release date: June 2025
