Endoscopic biliary drainage for biliary obstruction.
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.
Zhou
Ping-Hong
PH
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China. chow@zshospital.net
Yao
Li-Qing
LQ
Zhang
Yi-Qun
YQ
Gao
Wei-Dong
WD
He
Guo-Jie
GJ
Xu
Mei-Dong
MD
Wang
Ping
P
Qin
Xin-Yu
XY
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