{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:15:32Z","timestamp":1788909332559,"version":"build-2803163510"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Midlands Gastroenterological Society"},{"DOI":"10.13039\/100009795","name":"Pancreatic Cancer UK","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009795","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>National data suggest that biliary drainage for malignant obstruction is associated with high complication rates and early mortality. This study examined factors associated with poor outcomes.<\/jats:p><jats:p>RICOCHET was a national, prospective audit of patients with pancreatic cancer or malignant biliary obstruction between April and August 2018. This analysis reviewed outcomes including complications within 7 days and 30-day mortality following biliary drainage and associated factors.<\/jats:p><jats:p>Biliary drainage was attempted in 773 patients, of which, 78.7% were successful at first\n        attempt; but if unsuccessful, only 37% of subsequent attempts succeeded. Complications\n        occurred following 11% of endoscopic retrograde cholangiopancreatographies (ERCPs)\n        (including pancreatitis, 5%) and 12% of percutaneous transhepatic biliary drainages (PTBDs)\n        (including cholangitis, 8%). Complications were associated with: potentially resectable\n        cancer (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.23\u20133.03); more than one biliary\n        drainage attempt (OR 1.69, 95% CI 1.04\u20132.74); cholangiocarcinoma (OR 2.20, 95% CI\n        1.20\u20134.05), or radiological cancer diagnosis (OR 2.02, 95% CI 1.13\u20133.60). Thirty-day\n        mortality rates following ERCP and PTBD were 21.4% and 21.4%, respectively, in unresectable\n        cancer and 6% and 6.3%, respectively, in potentially resectable cancer. Increased 30-day\n        mortality in patients with unresectable disease was associated with a performance status of\n        2 or more (HR 3.14 (1.65\u20135.97)). Thirty-day mortality was significantly higher in patients\n        with unresectable cancer if a multidisciplinary team meeting had not reviewed and advised\n        drainage prior to the procedure 50% vs 20.4% (P = 0.028).<\/jats:p><jats:p>Careful multidisciplinary consideration of risks and potential benefits should be undertaken prior to attempting malignant biliary drainage due to the high risk of complications and early mortality.<\/jats:p>","DOI":"10.1055\/a-2558-6754","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:51:47Z","timestamp":1753318307000},"source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Outcomes and complications of biliary drainage for malignant biliary obstruction: National prospective study"],"prefix":"10.1055","volume":"13","author":[{"given":"Philip R","family":"Harvey","sequence":"first","affiliation":[{"name":"Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard RJ","family":"Wilkin","sequence":"first","affiliation":[{"name":"General Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5311-3090","authenticated-orcid":false,"given":"Shahd A.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Gastroenterology, Sandwell and West Birmingham NHS Trust, West Bromwich, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Powell-Brett","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery and Liver Transplantation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan C","family":"McKay","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery and Liver Transplantation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia R","family":"Layton","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracics, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary Surgery and Liver Transplantation, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Trudgill","sequence":"additional","affiliation":[{"name":"Gastroenterology, Sandwell and West Birmingham NHS Trust, West Bromwich, United Kingdom of Great Britain and Northern Ireland"},{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1111\/j.1572-0241.2007.01279.x","article-title":"Incidence rates of post-ERCP complications: a systematic survey of prospective studies","volume":"102","author":"A Andriulli","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.gie.2014.06.045","article-title":"Incidence, severity, and mortality 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