Naidu KSC, Giri S, Sahu SK, Praharaj DL, Mallick B, Nath P, Das S, Panigrahi SC, Sahu MK, Anand AC, Chawla YK, Acharya SK. Reduction of serum bilirubin levels after endoscopic biliary drainage in patients with extrahepatic biliary obstruction and its significance. World J Gastrointest Endosc 2026; 18(2): 116518 [PMID: 41700157 DOI: 10.4253/wjge.v18.i2.116518]
Corresponding Author of This Article
Bipadabhanjan Mallick, Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Kushabhadra Campus, 5 KIIT Road, Patia, Bhubaneswar 751024, Odisha, India. bipada.mallick@kims.ac.in
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kosuru Sham Charan Naidu, Suprabhat Giri, Saroj Kanta Sahu, Dibya Lochan Praharaj, Bipadabhanjan Mallick, Preetam Nath, Sarat Chandra Panigrahi, Manoj Kumar Sahu, Anil Chandra Anand, Yogesh K Chawla, Subrat Kumar Acharya, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Swati Das, Department of Radiology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Co-first authors: Kosuru Sham Charan Naidu and Suprabhat Giri.
Author contributions: Naidu KSC and Giri S drafted the initial manuscript and they contributed equally to this manuscript as co-first authors; Mallick B, Nath P, and Anand AC contributed to the conception and design of the manuscript; Naidu KSC, Giri S, Sahu SK, Praharaj DL, Mallick B, Nath P, Das S, Panigrahi SC, Sahu MK, Anand AC, Chawla YK, and Acharya SK contributed to the literature review, analysis, data collection, interpretation, and critical revision of the initial manuscript. All authors approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Kalinga Institute of Medical Sciences (approval No. KIIT/KIMS/IEC/1331/2023).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Dataset available from the corresponding author at bipada.mallick@kims.ac.in.
Corresponding author: Bipadabhanjan Mallick, Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Kushabhadra Campus, 5 KIIT Road, Patia, Bhubaneswar 751024, Odisha, India. bipada.mallick@kims.ac.in
Received: November 14, 2025 Revised: December 3, 2025 Accepted: January 6, 2026 Published online: February 16, 2026 Processing time: 82 Days and 14.3 Hours
Core Tip
Core Tip: Early bilirubin kinetics provide a simple, reliable, and clinically actionable tool after endoscopic biliary drainage for extrahepatic biliary obstruction. A ≥ 50% fall in bilirubin by day 7 indicates adequate drainage and predicts lower need for reintervention, whereas failure should prompt early reassessment for stent dysfunction or incomplete drainage. Achieving a bilirubin < 3 mg/dL by day 15 is a strong indicator of recovery, particularly in malignant obstruction; failure to do so predicts higher short-term mortality. Baseline bilirubin, alkaline phosphatase levels, etiology, and presence of acute kidney injury should guide the intensity of monitoring. Routine incorporation of bilirubin kinetics can improve post-endoscopic retrograde cholangiopancreatography decision-making and outcomes.
