Percutaneous biliary drainage. State of the art.

Abstract

Percutaneous biliary drainage is a minimally invasive procedure that allows decompression of the bile ducts in obstructive icteric syndromes, whether these occur in patients with malignant neoplasms of the biliary tree or in patients with benign bile duct lesions associated with surgery. Under the modality of documentary research of the state of the art, the systematic review was carried out using free access search engines such as PubMed, MedlinePlus, Scopus, Lilacs and the Google Scholar database. This is how the objective of verifying the clinical evidence on percutaneous biliary drainage (BPD) in the management of patients with biliary obstruction was fulfilled. Likewise, DBP constitutes an effective alternative to improve the conditions of the jaundiced patient before another major invasive procedure, as definitive therapy or as long-term palliative treatment in malignant diseases, unresectable tumors or in cases of high surgical risk. The access route is decided according to the characteristics of each specific patient. This is how high success rates of BPD have been reported in different studies in patients with obstructive jaundice due to neoplastic and non-neoplastic pathologies. However, these results are achieved by properly selecting patients in whom endoscopic retrograde cholangiopancreatography (ERCP) failed for some reason. In addition, it registers a low rate of complications. Therefore, it is concluded that a deep knowledge of the biliary anatomy and its variants is required, as well as technical considerations and an adequate selection of patients.