biostudies-literatureUnknown36(4)Dhar JMalignant hilar biliary obstruction (MHO) is a medical challenge as regards both forming a correct diagnosis and its adequate management, in terms of treatment alternatives and palliative options. Surgical resection is the only curative treatment for the underlying disease, but the majority of patients are not suitable candidates because of an unresectable tumor or poor performance status. Biliary drainage (BD) can be achieved through the percutaneous transhepatic route or endoscopically, and the choice depends on a host of factors, including biliary anatomy and comorbidity of the patient. Though there is no consensus, the endoscopic approach is usually preferred over the former. Endoscopy can aid in both diagnosis (collection of histological as well as cytological samples, direct visualizAnnals of gastroenterology347-359https://www.ebi.ac.uk/biostudies/studies/S-EPMC10304524biostudies-literatureThe role of endoscopy in malignant hilar obstruction.PMC10304524Samanta JGupta PDhar JfalseThe role of endoscopy in malignant hilar obstruction.Malignant hilar biliary obstruction (MHO) is a medical challenge as regards both forming a correct diagnosis and its adequate management, in terms of treatment alternatives and palliative options. Surgical resection is the only curative treatment for the underlying disease, but the majority of patients are not suitable candidates because of an unresectable tumor or poor performance status. Biliary drainage (BD) can be achieved through the percutaneous transhepatic route or endoscopically, and the choice depends on a host of factors, including biliary anatomy and comorbidity of the patient. Though there is no consensus, the endoscopic approach is usually preferred over the former. Endoscopy can aid in both diagnosis (collection of histological as well as cytological samples, direct visualiz2023-01-01T00:00:00Z2023 Jul-Aug2025-04-04T14:08:11.953Z2025-04-04T14:08:11.953ZS-EPMC103045243739599910.20524/aog.2023.0810