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Updated: Feb 13, 2026
07:44
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
6.8K
Is Palliative Percutaneous Drainage for Malignant Biliary Obstruction Useful?
Jarmo Niemelä1, Raija Kallio2, Pasi Ohtonen3
1Department of Surgery, Oulu University Hospital, Box 21, FIN-90029 OYS, Oulu, Finland. Jarmo.Niemela@ppshp.fi.
World Journal of Surgery
|March 15, 2018
Summary
Percutaneous biliary drainage for malignant biliary obstruction offers limited survival benefits, with factors like metastatic cancer and poor performance status predicting worse outcomes. Consider the utility of this intervention carefully in high-risk cancer patients.
Area of Science:
- Oncology
- Gastroenterology
- Interventional Radiology
Background:
- Malignant biliary obstruction presents a significant challenge in cancer patient care.
- Endoscopic drainage may be insufficient or unsuccessful for some patients.
Purpose of the Study:
- To identify predictive factors for survival in cancer patients undergoing percutaneous biliary drainage.
- To evaluate outcomes following percutaneous drainage when endoscopic methods fail.
Main Methods:
- Retrospective analysis of 643 cancer patients treated with percutaneous drainage between 1999 and 2016.
- Inclusion of patients with malignant biliary obstruction where endoscopic drainage was inadequate.
Main Results:
- Median overall survival was 2.6 months.
- Predictors of poor survival included metastatic cancer, Eastern Cooperative Oncology Group performance status (ECOG PS) of 2-4, American Society of Anesthesiologists (ASA) physical status classification of 4, and elevated bilirubin levels post-drainage.
- Outcomes improved in the later study period (2011-2016) compared to earlier periods.
Conclusions:
- Percutaneous biliary drainage in this cohort yielded poor median overall survival.
- The clinical utility of biliary drainage should be carefully assessed in patients with metastatic disease, poor ECOG PS, and high ASA class.
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