[Endoscopic drainage of the biliary system]

Area of Science:

• Gastroenterology
• Endoscopy
• Biliary Interventions

Background:

• Endoscopic biliary drainage has revolutionized the management of biliary tract diseases.
• Historically, biliary prostheses were primarily used for malignant obstructions, while nasobiliary catheters were favored for benign conditions.
• Recent innovations include self-expanding metallic stents (SEMS) to address stent occlusion, expanding their application in both benign and malignant cases.

Purpose of the Study:

• To review the indications for endoscopic biliary drainage.
• To evaluate the outcomes of nasobiliary catheter drainage.
• To assess the results of biliary prosthesis placement, including metallic stents.

Main Methods:

• Review of literature on endoscopic biliary drainage techniques.
• Analysis of clinical data pertaining to nasobiliary catheter use.
• Evaluation of studies reporting outcomes with biliary prostheses (plastic and metallic).

Main Results:

• Nasobiliary catheter drainage demonstrated good results with low morbidity and mortality, particularly in benign pathologies.
• Biliary prostheses, initially for malignant diseases, are now also used for benign conditions.
• Metallic autoexpandable prostheses have been introduced to overcome occlusion issues in both malignant and benign biliary obstructions.

Conclusions:

• Endoscopic biliary drainage with nasobiliary catheters and prostheses is a cornerstone in managing biliary problems.
• The choice between nasobiliary catheters and prostheses depends on the underlying pathology and specific clinical scenario.
• Advancements in stent technology, such as SEMS, continue to improve the efficacy and durability of endoscopic biliary interventions.