[Evaluation of Percutaneous Transhepatic Biliary Stent for Malignant Biliary Obstruction in Patients with Surgically Altered Anatomy].

For malignant biliary obstruction with surgically altered anatomy, endoscopic intervention is generally the first-line approach for palliative treatment. However, in cases with surgically altered anatomy, gastrointestinal stenosis, or difficulty in biliary cannulation, a percutaneous transhepatic approach may be required. In this study, we retrospectively analyzed 9 patients who underwent percutaneous transhepatic biliary stent at our institution between 2021 and 2024, focusing on the reasons for selecting this approach and the clinical outcomes. In addition to technical difficulties, logistical factors such as delays in endoscopic preparation also influenced the selection of this method. No major complications were observed, and the procedure was performed safely. Although advances in endoscopic techniques are expected to reduce the need for percutaneous interventions, this approach remains essential in selected cases, and maintaining the skillset for this technique continues to be a clinical challenge.