A new drainage method succeeds in 98.5% of cases where bile ducts are blocked by cancer.

Cancer can block the ducts that drain bile from the liver. Doctors call this malignant hilar biliary obstructionmalignant hilar biliary obstructionA blockage where the bile ducts exit the liver, caused by cancer, which stops bile from flowing into the intestine., and relieving it is difficult. To fix this, doctors can use an internal ultrasound camera to see the blocked tubes and place a drain. This technique is called endoscopic ultrasound-guided biliary drainageendoscopic ultrasound-guided biliary drainageA procedure where a doctor uses an endoscope with an ultrasound probe to guide a needle and stent into the blocked bile duct to drain it., or EUS-BD. Researchers studied patients who received this procedure either as their first treatment or as a rescue option after another method failed. The study found that doctors placed the drains successfully in almost every patient, and the treatment cleared the blockage in most of them. For people who improved, the blockage stayed clear for a median time of over six months. About one in ten patients had a procedure-related complication. The treatment was more likely to fail when patients had the most severe type of blockage, or when doctors drained only one or two segments of the liver.

Why it matters

For people with cancer blocking the bile ducts near the liver, draining bile is critical to relieve symptoms and enable treatment. This study shows that an endoscopic ultrasound-guided approach works well and is safe, offering an alternative when the standard method fails or isn't possible. It could expand options for patients who previously had few choices.

Questions answered