Non-surgical biliary drainage - technique, indications and results

Area of Science:

• Gastroenterology
• Interventional Radiology
• Surgical Oncology

Background:

• Malignant obstructive jaundice poses significant challenges in palliative care.
• Nonsurgical biliary drainage provides an alternative to surgical interventions for jaundice palliation.

Purpose of the Study:

• To evaluate the efficacy and safety of nonsurgical biliary drainage techniques.
• To assess the application of percutaneous transhepatic and transduodenal transpapillary approaches for biliary drainage.

Main Methods:

• Percutaneous transhepatic biliary drainage (external or internal endoprosthesis).
• Transduodenal, transpapillary approach with pigtail catheter or nasobiliary drainage tube.
• Papillotomy and papillar splitting were employed as needed.

Main Results:

• Successful biliary drainage was achieved in 67 patients.
• External drainage was primarily used for palliative care in inoperable biliodigestive system cancers.
• Pre-operative temporary drainage was performed to mitigate surgical risks in severe obstructive jaundice.
• Low complication rates including biliary peritonitis, cholangitis, and minor bleeds were observed.
• Technical failure rate was 10%.

Conclusions:

• Nonsurgical biliary drainage is a safe and effective therapeutic option for malignant obstructive jaundice.
• Both percutaneous and transduodenal approaches offer viable solutions for palliation and pre-operative management.
• The low complication and failure rates support the use of these minimally invasive techniques.