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Endoscopic Biliary Drainage for Malignant Obstructive Jaundice: Clinical Analysis and Assessment of Biliary Decompression
Author(s) -
KON Yoichi,
HIGUCHI Tsugio,
YOSHIHAMA Yutaka,
AOKI Takashi
Publication year - 1991
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1991.tb00523.x
Subject(s) - medicine , biliary drainage , decompression , stent , drainage , obstructive jaundice , jaundice , surgery , tube (container) , percutaneous , mechanical engineering , ecology , engineering , biology
The efficiency of non‐operative methods of biliary decompression was evaluated in 74 patients with malignant obstructive jaundice. Endoscopic biliary drainage (EBD) was performed in 54 patients and included nasobiliary drainage (NBD) in 18 patients, duodenobiliary drainage with a endoprosthetic tube measuring 7. 2 Fr in diameter (7.2DB) in 22 patients and duodenobiliary drainage with a endoprosthetic tube measuring 10 Fr in diameter (10DB) in 14 patients. 20 patients had percutaneous transhepatic biliary drainage (PTBD). A “Jaundice Reduction Index” was calculated for each group using the regression coefficient analysis of the fall in serum bilirubin levels measured at 1 week intervals. Values of 0.23, 0.30, 0.62 and 0.65 were obtained for the 10DB, 7.2DB, NBD and PTBD groups respectively. Our results indicate a statistically significant superiority in the efficiency of biliary decompression in the 10DB and 7.2DB patients when compared with the NBD and PTBD patients. The difference between the 10DB and the 7.2DB groups was not statistically significant. Moreover, endoprosthesis using a stent tube, measuring 7.2 Fr in diameter, provided sufficient biliary decompression on initial drainage. A stent tube with a larger diameter is preferable for endoprosthesis, but our results suggest that the use of stent tube with a bigger internal diameter is not necessary for the increased efficiency of biliary decompression.