ArticleWorld journal of gastrointestinal endoscopy2026
Reduction of serum bilirubin levels after endoscopic biliary drainage in patients with extrahepatic biliary obstruction and its significance.
Article in World journal of gastrointestinal endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEndoscopic retrograde cholangiopancreatography remains the primary modality for biliary decompression in extrahepatic biliary obstruction (EHBO). There are scarce data on the rate of fall in bilirubin after endoscopic biliary drainage (EBD) in EHBO.
aimTo evaluate the rate and determinants of serum bilirubin decline after EBD in patients with EHBO and their impact on patient outcomes.
methodsThis prospective observational study enrolled adults with EHBO and a serum total bilirubin level greater than 6 mg/dL who underwent endoscopic retrograde cholangiopancreatography from May 2023 to October 2024. Liver function tests were recorded at baseline and on days 1, 2, 7, and 15, and monthly thereafter. The primary outcome was the proportion of patients achieving a ≥ 50% decrease in bilirubin by day 7. Secondary outcomes included time to bilirubin < 3 mg/dL, predictors of biochemical response, need for reintervention, and 3-month mortality.
resultsAmong 101 patients, 60.4% had malignant EHBO. Overall, 80.2% achieved ≥ 50% bilirubin reduction by day 7, and 70.3% achieved bilirubin < 3 mg/dL by day 15. Benign etiology [adjusted odds ratio (aOR): 4.30;
conclusionFailure to achieve ≥ 50% fall by day 7 predicts reintervention, while inability to reach bilirubin < 3 mg/dL by day 15 predicts mortality. Bilirubin kinetics following EBD serve as reliable indicators of drainage adequacy and short-term prognosis in EHBO.
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