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Endoscopy 1990; 22(6): 259-262
DOI: 10.1055/s-2007-1012865
© Georg Thieme Verlag KG Stuttgart · New York

Malignant Common Bile Duct Obstruction: Factors Influencing the Success Rate of Endoscopic Drainage

J. Boender, G. A. J. J. Nix, H. E. Schütte, J. S. Laméris, M. van Blankenstein1 , J. Dees1
  • 1Department of Diagnostic Radiology and the Department of Internal Medicine II
  • University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands
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Publication History

Publication Date:
17 March 2008 (online)

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Summary

The problems encountered in draining the bile ducts endoscopically in 148 patients with malignant obstruction of the mid or distal common bile duct and/or the papilla were assessed. Endoscopically visible extrinsic invasion of the papilla by a malignancy in the pancreatic head, with or without duodenal stenosis, appeared to be the major reason for the failure to insert a stent. The larger a tumor in the pancreatic head the greater the chance of invasion of the papillary region. This appeared to be evident for tumors restricted to the non-uncinate region of the pancreatic head. We would recommend primary percutaneous biliary drainage or surgery when the size of a proven malignancy restricted to the non-uncinate region of the pancreatic head is 5 cm or more, or when diagnostic duodenoscopy reveals extrinsic invasion of the papilla of Vater, or severe duodenal involvement with stenosis.

Key words:

ERCP - Common bile duct - Malignant obstruction - Endoprosthesis

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