Endobiliary ablation before stenting in malignant biliary obstruction: the importance of patient selection “about”

This Letter to the Editor comments on the study by Demirci et al. evaluating percutaneous endobiliary ablation before stenting in malignant biliary obstruction. The letter emphasizes that the lack of improvement in stent patency or overall survival, together with increased complications, should be interpreted in the context of patient selection. Clarification of tumor type, obstruction level, baseline cholangitis, performance status, expected survival, and post-drainage oncologic treatment may improve the clinical applicability of the findings.