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The majority of patients with advanced <jats:styled-content style=\"fixed-case\">MHBO<\/jats:styled-content> are not candidates for surgical resection because of the tumor location in the hepatic hilum and adjacent areas, advanced tumor stage, or comorbidities. Therefore, these patients often have a poor prognosis in terms of survival and quality of life. Most of these patients will require non\u2010surgical, palliative biliary drainage. To date, various biliary drainage techniques for unresectable <jats:styled-content style=\"fixed-case\">MHBO<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>) have been reported. Of these techniques, endoscopic biliary drainage is currently considered to be the most safe and minimally invasive procedure. However, endoscopic biliary drainage for <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content> is still not standardized regarding the optimal stent, drainage area, stenting method, and reintervention technique. Recently, towards standardization of this technique for <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>, clinical research and trials including randomized controlled trials have been performed. In this article, we reviewed the most important issues regarding endoscopic biliary drainage for <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>, focusing on prospective studies. We also described in detail the techniques and future perspectives of endoscopic biliary drainage in patients with <jats:styled-content style=\"fixed-case\">UMHBO<\/jats:styled-content>.<\/jats:p>","DOI":"10.1002\/jhbp.186","type":"journal-article","created":{"date-parts":[[2014,11,7]],"date-time":"2014-11-07T09:01:15Z","timestamp":1415350875000},"source":"Crossref","is-referenced-by-count":24,"title":["Technical tips and troubleshooting of endoscopic biliary drainage for unresectable malignant hilar biliary obstruction"],"prefix":"10.1002","volume":"22","author":[{"given":"Hiroshi","family":"Kawakami","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Hokkaido University Hospital  Kita 14, Nishi 5, Kita\u2010ku Sapporo 060\u20108648 Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  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