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Updated: Aug 2, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
A possible role for ketorolac in the management of increased biliary drain output
Allen T Yu1, Nazanin Khajoueinejad1, Aliza Gross1
1Department of Surgery, Mount Sinai Hospital, New York, NY, United States of America.
Insights
High drain output from biliary drainage is a rare complication. Ketorolac, an analgesic, effectively reduced high biliary output in a patient with malignant biliary obstruction, offering a potential new treatment.
Area of Science:
- Gastroenterology
- Interventional Radiology
- Oncology
Background:
- Percutaneous transhepatic biliary drainage (PTBD) decompresses the biliary system in patients with obstructive jaundice.
- High drain output (>2000 mL/day) following PTBD is uncommon and can lead to dehydration and electrolyte imbalances.
- Currently, effective treatments for managing high drain output after PTBD are limited.
Abstract:
Percutaneous transhepatic biliary drainage is used to achieve biliary decompression in jaundiced patients with biliary obstruction. High drain output >2000 mL/day is rare, and can cause dehydration and electrolyte derangements, without effective treatments. We present the first patient, to our knowledge, who reacted to the use of the analgesic ketorolac with progressive reduction in biliary output, in the setting of malignant biliary obstruction from duodenal adenocarcinoma.
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