title: Endoscopic biliary drainage for biliary obstruction.
abstract: OBJECTIVE
  To improve the successful rate of endoscopic biliary drainage.
  
  
  METHODS
  Three hundred and fifty-two patients with biliary obstruction were given biliary drainage via duodenoscope from January 1998 to December 2002. 258 patients received endoscopic naso-biliary drainage (ENBD), 51 endoscopic retrograde biliary drainage (ERBD), and 43 endoscopic metal biliary endoprothesis (EMBE).
  
  
  RESULTS
  Of the 352 patients with biliary obstruction, 337 succeeded in drainage by endoscopy and 15 failed. Ten ENBD failed patients were handled successfully by readjustment of the site of the naso-biliary tube. In 3 ERBD failed patients, 2 were given plastic stents with appropriate length and got a fluent drainage. Percutaneous transhepatic biliary drainage (PTBD) was performed in one patient after failure of endoscopic management. In 2 patients with failed EMBE, one stent could not exceed the site of tumor stricture and one was obstructed by tumor implantation only one month after EMBE. Placement of another metallic stent and a plastic stent through the previous prothesis for each patient ensured a successful drainage.
  
  
  CONCLUSIONS
  The effect of endoscopic biliary drainage for biliary obstruction is definite. Drainage failure can be avoided or remedied as early as possible by taking some active measures.
authors: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. chow@zshospital.net
authors: Ping-Hong
authors: PH
authors: Zhou
authors: Li-Qing
authors: LQ
authors: Yao
authors: Yi-Qun
authors: YQ
authors: Zhang
authors: Wei-Dong
authors: WD
authors: Gao
authors: Guo-Jie
authors: GJ
authors: He
authors: Mei-Dong
authors: MD
authors: Xu
authors: Ping
authors: P
authors: Wang
authors: Xin-Yu
authors: XY
authors: Qin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D004322:Drainage / Q000379:methods; D004384:Duodenoscopy / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome