MANAGEMENT AND PROBLEM OF ENDOSCOPIC BILIARY DRAINAGE

Transpapillary biliary drainage has developed as an applied technique of endoscopic retrograde cholangiopancreatography and spread as a routine procedure. Particularly, endoscopic biliary drainage (EBD), which is characterized by physiologic nature, mild invasiveness, and no restriction of life, is a reasonable and efficient method for temporary or permanent biliary drainage. Also, improvements in the stent material, increases in the stent diameter, and advent of metallic stents have solved many problems with EBD. However, despite the improvements in various imaging techniques and development of surgical procedures and multidisciplinary treatment, many old as well as new problems such as the selection of the drainage method, stenting method, stent patency rate, stent material, and concomitant treatments still remain. For a more effective clinical use of EBD, the selection of the optimal drainage method and stent for individual patients and the development of stents and basic clinical research from the viewpoints of concomitant treatments are necessary.