Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Jun 16, 2026; 18(6): 121737
Published online Jun 16, 2026. doi: 10.4253/wjge.v18.i6.121737
Published online Jun 16, 2026. doi: 10.4253/wjge.v18.i6.121737
Endoscopic biliary drainage techniques for bilirubin normalization in distal malignant biliary obstruction: A comprehensive review
Alberto Martino, Francesco Paolo Zito, Luigi Orsini, Giovanni Lombardi, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Antonino Granata, Interventional Endoscopic Unit, Buccheri La Ferla Hospital, Palermo 90123, Italy
Massimiliano Lombardi, Giuseppe Galloro, Surgical Endoscopy Unit, Department of Clinical Medicine and Surgery, University “Federico II” of Naples, Napoli 80131, Italy
Roberto Fiorentino, Ferdinando Riccardi, Department of Oncology, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Claudio Carrubba, Raffaella Niola, Department of Interventional Radiology, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Carlo Molino, Department of Oncological Surgery, AORN “Antonio Cardarelli”, Napoli 80131, Italy
Author contributions: Martino A, Granata A, and Zito FP designed the research, wrote and edited the manuscript, and finalized the text; Martino A, Granata A, Zito FP, Lombardi M, Fiorentino R, Carrubba C, and Orsini L performed the literature search and analyzed the data; Niola R, Riccardi F, Galloro G, Molino C, and Lombardi G reviewed the paper for important intellectual content; and all authors have read and approved the final manuscript.
AI contribution statement: The authors take full responsibility for the accuracy, integrity, and originality of the manuscript. AI tools were not used to generate data, perform analyses, or draw scientific conclusions.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Corresponding author: Alberto Martino, MD, Department of Gastroenterology and Digestive Endoscopy, AORN “Antonio Cardarelli”, Via Antonio Cardarelli 9, Napoli 80131, Italy.
Received: March 31, 2026
Revised: April 30, 2026
Accepted: May 15, 2026
Published online: June 16, 2026
Processing time: 71 Days and 8.5 Hours
Revised: April 30, 2026
Accepted: May 15, 2026
Published online: June 16, 2026
Processing time: 71 Days and 8.5 Hours
Core Tip
Core Tip: Endoscopic retrograde cholangiopancreatography remains the gold standard for distal malignant biliary obstruction (DMBO), with endoscopic ultrasound-guided biliary drainage emerging as a promising alternative. However, evidence regarding bilirubin normalization rates across these modalities is lacking. Our study reviews the available evidence to evaluate the efficacy of endoscopic biliary drainage techniques in normalizing bilirubin levels in patients with DMBO.