Modern possibilities of minimally invasive biliary drainage techniques for patients with malignant jaundice
DOI:
https://doi.org/10.14739/2310-1210.2024.6.312082Keywords:
obstructive jaundice, bile ducts, drainage, laparoscopes, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiostomy, endobiliary stentingAbstract
Malignant biliary obstruction is a complex condition requiring a multimodal approach for both diagnosis and treatment. Most patients diagnosed with this disease are not candidates for radical surgery, as they come to us at advanced stages of the disease. Therefore, they need quality palliative care.
Aim. Based on the data from scientific articles and literature, to highlight the possibilities of minimally invasive biliary drainage techniques in patients with malignant jaundice.
The article analyzes the available sources of scientific literature and articles from the electronic resources PubMed, Google Scholar, UpToDate from 2019 to 2024. Minimally invasive methods of biliary drainage have demonstrated significant advantages over open surgeries, including a reduced risk of surgical complications, shorter rehabilitation period, and the ability to perform the procedure under local anesthesia. However, despite technological progress and accumulated clinical experience, a number of unresolved issues remain, in particular, related to choosing the optimal drainage method for a particular patient, and assessing the effectiveness and safety of a specific technique.
Conclusions. The most controversial issue is the choice between endoscopic and percutaneous drainage methods. Some studies have shown that endoscopic drainage might be more effective in patients with tumors located in the distal bile ducts, while percutaneous drainage might be more appropriate in case of proximal obstructions. Therefore, the situation calls for additional studies to evaluate long-term results of different drainage techniques and the effectiveness of plastic, covered and uncovered metal stents in different clinical situations.
References
Fernandez Y Viesca M, Arvanitakis M. Early Diagnosis And Management Of Malignant Distal Biliary Obstruction: A Review On Current Recommendations And Guidelines. Clin Exp Gastroenterol. 2019;12:415-32. doi: https://doi.org/10.2147/CEG.S195714
Okamoto T. Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer. World J Gastroenterol. 2022;28(10):985-1008. doi: https://doi.org/10.3748/wjg.v28.i10.985
Liu JJ, Sun YM, Xu Y, Mei HW, Guo W, Li ZL. Pathophysiological consequences and treatment strategy of obstructive jaundice. World J Gastrointest Surg. 2023;15(7):1262-76. doi: https://doi.org/10.4240/wjgs.v15.i7.1262
Mocan T, Horhat A, Mois E, Graur F, Tefas C, Craciun R, et al. Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma: When and how? World J Gastrointest Oncol. 2021;13(12):2050-63. doi: https://doi.org/10.4251/wjgo.v13.i12.2050
O'Brien S, Bhutiani N, Egger ME, Brown AN, Weaver KH, Kline D, et al. Comparing the efficacy of initial percutaneous transhepatic biliary drainage and endoscopic retrograde cholangiopancreatography with stenting for relief of biliary obstruction in unresectable cholangiocarcinoma. Surg Endosc. 2020;34(3):1186-90. doi: https://doi.org/10.1007/s00464-019-06871-2
Bezrodnyi BG, Kolosovich IV, Slobodjanyk VP, Petrenko OM, Filatov MS. [Palliative surgical treatment of unresectable tumors of the head of the pancreas complicated by mechanical jaundice and duodenal obstruction by stenting of the biliary system and duodenum with nitinol stents]. Kharkivska khirurhichna shkola. 2022;0(2):33-6. Ukrainian. doi: https://doi.org/10.37699/2308-7005.2.2022.06
Parkhomenko KY, Drozdova AG, Payunov KY, Shadrin OV. [Optimization of treatment of patients with pancreatic cancer complicated by mechanical jaundice]. Kharkivska khirurhichna shkola. 2022;0(4-5):65-9. Ukrainian. doi: https://doi.org/10.37699/2308-7005.4-5.2022.13
Jang DK, Kim J, Yoon SB, Yoon WJ, Kim JW, Lee TH, et al. Palliative endoscopic retrograde biliary drainage for malignant biliary obstruction in Korea: A nationwide assessment. Saudi J Gastroenterol. 2021;27(3):173-7. doi: https://doi.org/10.4103/sjg.sjg_589_20
Shevchuk M, Dudchenko M, Kravtsiv M, Ivashchenko D, Prykhidko R, Zaiets S. [Features of decompression of the biliary tract in patients with obturation of the distal part of the common bile duct of tumor origin]. The Medical and ecological problems. 2022;26(3-4):30-3. Ukrainian. doi: https://doi.org/10.31718/mep.2022.26.3-4.04
Paik WH, Park DH. Endoscopic Management of Malignant Biliary Obstruction. Gastrointest Endosc Clin N Am. 2024;34(1):127-40. doi: https://doi.org/10.1016/j.giec.2023.07.004
Judah JR, Draganov PV. Endoscopic therapy of benign biliary strictures. World J Gastroenterol. 2007;13(26):3531-9. doi: https://doi.org/10.3748/wjg.v13.i26.3531
Huynh R, Owers C, Pinto C, Nguyen TM, Kwok T. Endoscopic Evaluation of Biliary Strictures: Current and Emerging Techniques. Clin Endosc. 2021;54(6):825-32. doi: https://doi.org/10.5946/ce.2021.048
Wang D, Lin H, Guan C, Zhang X, Li P, Xin C, et al. Impact of preoperative biliary drainage on postoperative complications and prognosis after pancreaticoduodenectomy: A single-center retrospective cohort study. Front Oncol. 2022;12:1037671. doi: https://doi.org/10.3389%2Ffonc.2022.1037671
Rustgi SD, Amin S, Yang A, Kim MK, Nagula S, Kumta NA, et al. Preoperative Endoscopic Retrograde Cholangiopancreatography Is Not Associated With Increased Pancreatic Cancer Mortality. Clin Gastroenterol Hepatol. 2019;17(8):1580-6.e4. doi: https://doi.org/10.1016/j.cgh.2018.11.056
Spadaccini M, Giacchetto CM, Fiacca M, Colombo M, Andreozzi M, Carrara S, et al. Endoscopic Biliary Drainage in Surgically Altered Anatomy. Diagnostics (Basel, Switzerland). 2023;13(24):3623. doi: https://doi.org/10.3390/diagnostics13243623
Chi JY, Ma LY, Zou JC, Ma YF. Risk factors of pancreatitis after endoscopic retrograde cholangiopancreatography in patients with biliary tract diseases. BMC Surg. 2023;23(1):62. doi: https://doi.org/10.1186/s12893-023-01953-4
Bao G, Liu H, Ma Y, Li N, Lv F, Dong X, et al. The clinical efficacy and safety of different biliary drainages in malignant obstructive jaundice treatment. Am J Transl Res. 2021;13(6):7400-5.
Gupta P, Maralakunte M, Kalra N, Samanta J, Sharma V, Mandavdhare H, et al. Feasibility and safety of bedside percutaneous biliary drainage in patients with severe cholangitis. Abdom Radiol (NY). 2021;46(5):2156-60. doi: https://doi.org/10.1007/s00261-020-02825-8
Wang Y, Wen N, Xiong X, Li B, Lu J. Biliary drainage in malignant biliary obstruction: an umbrella review of randomized controlled trials. Front Oncol. 2023;13:1235490. doi: https://doi.org/10.3389/fonc.2023.1235490
Yuan P, Zhang L, Li S, Li X, Wu Q. Clinical results after biliary drainage by endoscopic retrograde cholangio-pancreatography for analysis of metastatic cancer survival and prognostic factors. Surg Endosc. 2021;35(11):6220-6. doi: https://doi.org/10.1007/s00464-020-08121-2
Rizzo A, Ricci AD, Frega G, Palloni A, DE Lorenzo S, Abbati F, et al. How to Choose Between Percutaneous Transhepatic and Endoscopic Biliary Drainage in Malignant Obstructive Jaundice: An Updated Systematic Review and Meta-analysis. In Vivo. 2020;34(4):1701-4. doi: https://doi.org/10.21873/invivo.11964
Termsinsuk P, Charatcharoenwitthaya P, Pausawasdi N. Development and validation of a 90-day mortality prediction model following endobiliary drainage in patients with unresectable malignant biliary obstruction. Front Oncol. 2022;12:922386. doi: https://doi.org/10.3389/fonc.2022.922386
Thomaidis T, Kallimanis G, May G, Zhou P, Sivanathan V, Mosko J, Triantafillidis JK, Teshima C, Moehler M. Advances in the endoscopic management of malignant biliary obstruction. Ann Gastroenterol. 2020;33(4):338-47. doi: https://doi.org/10.20524/aog.2020.0497
Lee TH, Moon JH, Stuart S. Role of ERCP in Malignant Hilar Biliary Obstruction. Gastrointest Endosc Clin N Am. 2022;32(3):427-53. doi: https://doi.org/10.1016/j.giec.2022.01.003
Tanisaka Y, Mizuide M, Fujita A, Ogawa T, Katsuda H, Saito Y, et al. Current Status of Endoscopic Biliary Drainage in Patients with Distal Malignant Biliary Obstruction. J Clin Med. 2021;10(19):4619. doi: https://doi.org/10.3390/jcm10194619
Wu CH, Wang SF, Lee MH, Tsou YK, Lin CH, Chang LL, et al. Efficacy of Fully Covered Self-Expandable Metal Stents for Distal Biliary Obstruction Caused by Pancreatic Ductal Adenocarcinoma: Primary Metal Stent vs. Metal Stent following Plastic Stent. Cancers (Basel). 2023;15(11):3001. doi: https://doi.org/10.3390/cancers15113001
Gu J, Guo X, Sun Y, Fan B, Li H, Luo T, et al. Efficacy and complications of inoperable malignant distal biliary obstruction treatment by metallic stents: fully covered or uncovered? Gastroenterol Rep (Oxf). 2023;11:goad048. doi: https://doi.org/10.1093/gastro/goad048
Kumar S, Singh P, Kumar V, Kumar M, Mahto M. Survival benefit of percutaneous transhepatic biliary drainage for malignant biliary tract obstruction-a prospective study comparing external and internal drainage techniques. Abdom Radiol (NY). 2021;46(11):5408-16. doi: https://doi.org/10.1007/s00261-021-03215-4
Wang L, Lin N, Xin F, Ke Q, Zeng Y, Liu J. A systematic review of the comparison of the incidence of seeding metastasis between endoscopic biliary drainage and percutaneous transhepatic biliary drainage for resectable malignant biliary obstruction. World J Surg Oncol. 2019;17(1):116. doi: https://doi.org/10.1186/s12957-019-1656-y
She WH, Cheung TT, Ma KW, Yin Tsang SH, Dai WC, Yan Chan AC, et al. Impact of preoperative biliary drainage on postoperative outcomes in hilar cholangiocarcinoma. Asian J Surg. 2022;45(4):993-1000. doi: https://doi.org/10.1016/j.asjsur.2021.07.075
Subramani VN, Avudaiappan M, Yadav TD, Kumar H, Sharma V, Mandavdhare H, et al. Outcome Following Percutaneous Transhepatic Biliary Drainage (PTBD) in Carcinoma Gallbladder: a Prospective Observational Study. J Gastrointest Cancer. 2022;53(3):543-8. doi: https://doi.org/10.1007/s12029-021-00655-5
Bian C, Fang Y, Xia J, Shi L, Huang H, Xiong Q, et al. Is percutaneous drainage better than endoscopic drainage in the management of patients with malignant obstructive jaundice? A meta-analysis of RCTs. Front Oncol. 2023;13:1105728. doi: https://doi.org/10.3389/fonc.2023.1105728
Boyko VV, Avdosyev YV, Yevtushenko DO, Sochneva AL, Taraban IA, Smachilo RM, et al. [Antegrade endobiliary interventions in patients with unresectable biliary tract malignant neoplasms complicated by jaundice]. Kharkivska khirurhichna shkola. 2022;0(6):28-1. Ukrainian. doi: https://doi.org/10.37699/2308-7005.6.2022.06
Susak YM, Markulan LL, Lobanov SM, Palitsya RY, Rudyk MP, Skivka LM. Effectiveness of a new approach to minimally invasive surgery in palliative treatment of patients with distal malignant biliary obstruction. World J Gastrointest Surg. 2023 Apr 27;15(4):698-711. doi: https://doi.org/10.4240/wjgs.v15.i4.698
Gopakumar H, Singh RR, Revanur V, Kandula R, Puli SR. Endoscopic Ultrasound-Guided vs Endoscopic Retrograde Cholangiopancreatography-Guided Biliary Drainage as Primary Approach to Malignant Distal Biliary Obstruction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Gastroenterol. 2024;119(8):1607-15. doi: https://doi.org/10.14309/ajg.0000000000002736
Giri S, Seth V, Afzalpurkar S, Angadi S, Jearth V, Sundaram S. Endoscopic Ultrasound-guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-analysis. Surg Laparosc Endosc Percutan Tech. 2023;33(4):411-9. doi: https://doi.org/10.1097/SLE.0000000000001192
Minaga K, Takenaka M, Ogura T, Tamura T, Kuroda T, Kaku T, et al. Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction with surgically altered anatomy: a multicenter prospective registration study. Therap Adv Gastroenterol. 2020;13:1756284820930964. doi: https://doi.org/10.1177/1756284820930964
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