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Endoscopic Biliary Drainage in Malignant Biliary Strictures: A Prospective Analysis Based on Real-World Data
Julio Zuniga Cisneros1,2, Alexis Mc-Kenzie3, Ivan Ramos3
1Department of Gastroenterology, Instituto Oncologico de Panama, Panama City, Panama.
Gastroenterology Research
|July 21, 2025
Summary
Endoscopic retrograde cholangiopancreatography (ERCP) offers effective palliative drainage for malignant biliary strictures (MBS). However, malignant hilar strictures require individualized management due to higher complication and stent dysfunction rates.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Malignant biliary strictures (MBS) are often palliated with endoscopic biliary drainage.
- Endoscopic retrograde cholangiopancreatography (ERCP) is the standard for this procedure.
Purpose of the Study:
- To investigate outcomes of ERCP for MBS.
- Evaluate stent dysfunction (SD) and mortality over 12 months.
- Assess technical and functional success rates based on stricture location and stent type.
Main Methods:
- Prospective study of 147 patients with MBS undergoing ERCP.
- Evaluation of technical and functional stent deployment.
- 12-month follow-up for stent dysfunction and mortality.
Main Results:
- Distal strictures had higher technical (96.3%) and functional (75.8%) success than hilar strictures (32.4% technical, 58.8% functional).
- Overall stent dysfunction (SD) was 46.9%; mortality was 43.5%.
- Hilar strictures showed higher complication rates, particularly bacteremia.
Conclusions:
- ERCP interventions for MBS demonstrate high success and low adverse events.
- Malignant hilar strictures require tailored endoscopic management due to increased SD and complications.
