Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN:
1312 773X (Online)
Issue:
2013, vol. 19, book 3;
Subject Collection:
Medicine
Page: 465-469
DOI: 10.5272/jimab.2013193.465
Published online: 20 November 2013
J of IMAB. 2013 Jul-Dec;19(3):465-469
BILIARY DRAINAGE
Nikola Y. Kolev1, Valentin L. Ignatov1, Anton Y. Tonev1 


, Aleksandar K. Zlatarov1, Elitsa P. Encheva2, Tanya N. Kirilova1, Vasil M. Bojkov3, Krasimir D. Ivanov1.
1) Department of General and Operative Surgery, 2) Department of Nuclear Medicine, Metabolic Therapy and Radiotherapy, 3) Department of Surgical Diseases
University Hospital “St. Marina” Varna, Bulgaria, Medical University of Varna, Bulgaria.
.
ABSTRACT:
In patients with obstructive jaundice, when the endoscopic approach fails to achieve biliary drainage, percutaneous cannulation and combined endoscopic/percutaneous endoprosthesis insertion can be performed simultaneously or in stages. This study compared these two approaches. Endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic biliary drainage (PTBD) are the two main non-surgical treatment options for obstructive jaundice in patients with HCC. ERBD is usually the first-line treatment because of its low hemorrhage risk. Mean stent patency time and mean survival range from 1.0 to 15.9 and 2.8 to 12.3 months, respectively. The dominant effect of biliary drainage suggests that successful jaundice therapy could enhance anti-cancer treatment by increasing life expectancy, decreasing mortality, or both. We present an overview of the efficacy of endoscopic and percutaneous drainage for obstructive jaundice in patients with HCC who are not candidates for surgical resection and summarize the current indications and outcomes of reported clinical use.
Key words: obstructive jaundice; Endoscopic retrograde biliary drainage (ERBD); overview; percutaneous drainage;
- Download FULL TEXT /PDF 551 KB/
Please cite this article as:
Kolev NY, Ignatov VL, Tonev AY, Zlatarov AK, Encheva EP, Kirilova TN, Bojkov VM, Ivanov KD. BILIARY DRAINAGE. J of IMAB. 2013 Jul-Dec;19(3):465-469. DOI: 10.5272/jimab.2013193.465.
Correspondence to: Anton Y. Tonev, University Hospital "St. Marina", Medical University of Varna; 1, Hristo Smirnenski Blvr., Varna, Bulgaria.; E-mail: teraton@abv.bg;
REFERENCES:
1. Yee AC, Ho CS. Percutaneousbiliary drainage: a review. Crit ReveDiagn Imaging. 1990 30(3):247–279. [PubMed]
2. Fidelman N, Kerlan RK Jr, Laberge JM, Gordon RL. Accuracy of percutaneous transhepatic cholangiography in predicting the location and nature of major bile duct injuries.. J Vasc Interv Radiol. 2011 Jun;22(6):884-92. Epub 2011 Apr 22. [PubMed] [CrossRef]
3. Tapping CR, Byass OR, Cast JE. Percutaneous transhepatic biliary drainage (PTBD) with or without stenting-complications, re-stent rate and a new risk stratification score. Eur Radiol. 2011 Sep;21(9):1948-55. Epub 2011 May 1. [PubMed] [CrossRef]
4. Kaude JV, Weidenmier CH, Agee OF. Decompression of bile ductswith the percutaneous transhepatictechnique. Radiology. 1969 Jul;93(1):69–71. [PubMed]
5. Molnar W, Stockum AE. Reliefof obstructive jaundice through percutaneous transhepatic catheter. A newtherapeutic method. Am J Roentgenol Radium Ther Nucl Med. 1974 Oct;122(2):356–367. [PubMed]
6. Ferruci JT Jr, Mueller PR, Harbin WP. Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology. 1980 Apr;135(1):1–13. [PubMed]
7. McPherson GA, Benjamin JS, Habib NA, Bowley NB, Blumgart LH. Percutaneous transhepatic drainage inobstructive jaundice: advantages andproblems. Br J Surg. 1982 May;69(5):261–264. [PubMed]
8. Laméris JS, Obertop H, Jeekel J. Biliary drainage by ultrasound-guidedpuncture of the left hepatic duct. Clin Radiol.1985 May;36(3):269–274. [PubMed]
9. Günther RW, Schild H, Thelen M. Review article: percutaneous transhepatic biliary drainage. Experience with 311 procedures. Cardiovasc Intervent Radiol. 1988 Apr;11(2):65-71. [PubMed]
10. Lammer J, Hausegger KA, Fluckiger F, Winkelbauer FW, Wildling R, KleinGE, et al. Common bile duct obstruction due tomalignancy: treatment with plastic versus metal stents. Radiology. 1996 Oct;201(1):167–172. [PubMed]
11. Indar AA, Lobo DN, Gilliam AD,Gregson R, Davidson I, Whittaker S, et al. Percutaneous biliary metal wallstenting in malignant obstructive jaundice. Eur J Gastroenterol Hepatol. 2003 Aug;15(8):915-919. [PubMed]
12. Lee BH, Choe DH, Lee JH, Kim KH, Chin SY. Metallic stents inmalignant biliary obstruction: prospective long-term results. AJR Am J Roentgenol. 1997 Mar;168(3):741–745. [PubMed] [CrossRef]
13. Bezzi M, Zolovkins A, Cantisani V, Salvatori FM, Rossi M, Fanelli F, et al. New ePTFE/FEP-coveredstent in the palliative treatment of malignant biliary obstruction. J Vasc Interv Radiol. 2002 Jun;13(6):581–589. [PubMed]
14. Schoder M, Rossi P, Uflacker R, Bezzi M, Stadler A, Funovics MA, et al. Malignant biliaryobstruction: treatment with ePTFE-FEP-covered endoprostheses initialtechnical and clinical experiences in a multicenter trial. Radiology. 2002 Oct;225(1):35–42. [PubMed]
15. Hausegger KA, Thurnher S, Bodendorfer G, Zollikofer CL, Uggowitzer M, Kugler C, et al. (1998) Treatment of malignant biliaryobstruction with polyurethane-covered Wallstents. AJR Am J Roentgenol. Feb;170(2):403–408. [PubMed] [CrossRef]
16. Miyayama S, Matsui O, Akakura Y, Yamamoto T, Nishida H, Yoneda K, et al. Efficacy of coveredmetallic stents in the treatment ofunresectable malignant biliary obstruction. Cardiovasc Intervent Radiol. 2004 Jul-Aug;27(4):349–354. [PubMed] [CrossRef]
17. Freeman ML, Overby C. Selective MRCP and CT-targeted drainage ofmalignant hilar biliary obstruction withself-expanding metallic stents.Gastrointest Endosc.2003 Jul;58(1):41–49. [PubMed] [CrossRef]
18. Lillemoe KD, Sauter PK, Pitt HA, Yeo CJ, Cameron JL. Current status ofsurgical palliation of periampullary carcinoma. Surg Gynecol Obstet. 1993 Jan;176(1):1–10. [PubMed]
19. Van Wagensveld, Coene PP, Van Gulik TM, Rauws EA, Obertop H, Gouma DJ. Outcome of palliative biliaryand gastric bypass surgery for pancreatichead carcinoma in 126 patients. BrJ Surg. 1997 Oct;84(10):1402–1406. [PubMed]
20. Lesurtel M, Dehni N, Tiret E, Parc R, Paye F. Palliative surgery forunresectable pancreatic and periampullary cancer: a reappraisal. J GastrointestSurg. 2006 Feb;10(2):286–291. [PubMed]
21. Smith AC, Dowsett JF, Russell RC, Hatfield AR, Cotton PB. Randomisedtrial of endoscopic stenting versus surgical bypass in malignant low bileduct obstruction. Lancet. 1994 Dec 17;344(8938):1655–1660. [PubMed]
22. Andersen JR, Sorensen SM, Kruse A, Rokkjaer M, Matzen P. Randomised trial of endoscopic endoprothesisversus operative bypass in malignant obstructive jaundice. Gut. 1989 Aug;30(8):1132–1135. [PubMed]
23. Hyoty MK, Nordback IH. Biliarystent or surgical bypass in unresectable pancreatic cancer withobstructive jaundice. Acta Chir Scand. 1990 May;156(5):391–396. [PubMed]
24. Shepherd HA, Royle HA, Ross AP, Diba A, Arthur M, Colin-Jones D. Endoscopic biliary endoprothesisin the palliation of malignantobstruction of the distal common bileduct: a randomized trial. Br J Surg. 1988 Dec;75(12):1166–1168. [PubMed]
25. Bornman PC, Harries-Jones EP, Tobias R, Van Stiegmann G, Terblanche J. Prospective controlled trial of transhepaticbiliary endoprosthesis versus bypasssurgery for incurable carcinoma ofhead of pancreas. Lancet. 1986 Jan 11;1(8472):69–71. [PubMed]
26. Raikar GV, Melin MM, Ress A, LettieriSZ, Poterucha JJ, Nagorney DM, et al. Cost-effective analysis of surgical palliation versusendoscopic stenting in the managementof unresectable pancreatic cancer. AnnSurg Oncol. 1996 3:470–475
27. Taylor MC, McLeod RS, Langer B. Biliary stenting versus bypasssurgery for the palliation of malignantdistal bile duct obstruction: a metaanalysis. Liver Transpl. (2000) 6:302–308
28. van den Bosch RP, van der Schelling GP, Klinkenbijl JH, Mulder PG, van Blankenstein M, Jeekel J Guidelines for the application of surgeryand endoprostheses in the palliation of obstructive jaundice in advanced cancerof the pancreas. Ann Surg. 1994 Jan;219(1):18–24. [PubMed]
29. Moss AC, Morris E, Mac Mathuna P. Palliative biliary stents for obstructing pancreatic carcinoma. CochraneDatabase Syst Rev. 2006 Apr 19;(2):CD004200. [PubMed] [CrossRef]
30. Kaw M, Singh S, Gagneja H, Azad P. Role of self-expandable metalstents in the palliation of malignantduodenal obstruction. Surg Endosc. (2003) 17:646–650
31. Singal D, Van Gulik TM, Gouma DJ. (2005) Palliative management of hilarcholangiocarcinoma. Surg Oncol14:59–74
32. Rumalla A, Baron TH (1999) Evaluationand endoscopic palliation of cholangiocarcinoma. Management ofcholangiocarcinoma. Dig Dis. 17:194–200
33. Jarnagin WR, Shoup M. Surgical management of cholangio carcinoma. Semin Liver Dis. 2004 May; 24(2):189–199. [PubMed] [CrossRef]
34. Pinol V, Castelis A, Bordas JM, RealMI, Llach J, Montana X, et al. Percutaneous self-expandingmetal stents versus endoscopicpolyethylene endoprostheses fortreating malignant biliary obstruction: randomized clinical trial. Radiology. 2002 Oct;225(1):27–34. [PubMed] [CrossRef]
35. Naggar E, Krag E, Matzen P. Endoscopically inserted biliary endoprostesisin malignant obstructivejaundice. A survey of the literature. Liver<. 1990 Dec;10(6):321–324. [PubMed]
36. Dowsett JF, Vaira D, Hatfield AR, Cairns SR, Polydorou A, Frost R, Croker J, Cotton PB, Russell RC, Mason RR. Endoscopic biliary therapy using the combined percutaneous and endoscopic technique. Gastroenterology. 1989 Apr;96(4):1180-6. [PubMed]
37. Kaufman SL. Percutaneous palliationof unresectable pancreatic cancer. Surg Clin North Am. 1995 Oct;75(5):989–999. [PubMed]
38. Davids PH, Groen AK, Rauws EA,Tygtat GN, Huibregste K. Randomized trial of self-expanding metalstents versus polyethylene stents fordistal malignant biliary obstruction. Lancet.1992 Dec 19-26;340(8834-8835):1488-92. [PubMed] [CrossRef]
39. Wagner HJ, Knyrim K, Vakil N, Klose KJ. Plastic endoprostheses versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomized trial. Endoscopy. 1993 Mar;25(3):213–218. [PubMed] [CrossRef]
40. Harewood GC, Baron TH, LeRoy AJ, Petersen BT. Cost-effectiveness analysis of alternative strategies for palliation of distal biliary obstruction after a failed cannulation attempt. Am JGastroenterol. 2002 Jul;97(7):1701–1707. [PubMed] [CrossRef]
41. Yeoh KG, Zimmerman MJ, Cunningham JT, Cotton PB. Comparative costs of metal versus plasticbiliary stent strategies for malignant obstructive jaundice by decision analysis. Gastrointest Endosc. 1999 Apr;49(4 Pt 1):466–471. [PubMed]
42. Cheng JL, Bruno MJ, Bergman JJ, Rauws EA, Tytgay GH, Huibregtse K. Endoscopic palliation of patientswith biliary obstruction caused bynonresectable hilar cholangiocarcinoma: efficacy of self-expandable metallic Wallstents. Gastrointest Endosc. 2002 Jul;56(1):33–39. [PubMed] [CrossRef]
43. Ducreux M, Liguory C, Lefebvre JF, Ink O, Choury A, Fritsch J, et al. Managementof malignant hilar biliary obstruction byendoscopy. Results and prognostic factors. Dig Dis Sci. 1992 May;37(5):778–783. [PubMed].
Accepted for publication: 21 August 2013
Published online: 20 November 2013
back to Online Journal