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Title: Malignant common bile duct obstruction: factors influencing the success rate of endoscopic drainage. Author: Boender J, Nix GA, Schütte HE, Laméris JS, van Blankenstein M, Dees J. Journal: Endoscopy; 1990 Nov; 22(6):259-62. PubMed ID: 2176972. Abstract: 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.[Abstract] [Full Text] [Related] [New Search]