Karim MM, Moatter S, Amin M, Parkash O. Comparison of endoscopic retrograde cholangiopancreatography drainage vs percutaneous transhepatic biliary drainage in severe cholangitis: A study from low-middle income country. World J Gastrointest Pharmacol Ther 2025; 16(3): 107167 [PMID: 40937286 DOI: 10.4292/wjgpt.v16.i3.107167]
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08549003
Submitted on:
September 05, 2025, 07:12
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Reader Comments:
PTBD and ERCP are the commonly used methods for biliary drainage. In low-income settings, advanced techniques such as EUS-guided therapies are often unavailable, limiting clinicians' options. This study compares the efficacy of PTBD and ERCP in a low-income country. Both groups showed good therapeutic success, but the PTBD group had low clinical success. This difference may be due to the type of patients enrolled in PTBD, most likely those with Bismuth type 3/4, for which PTBD is typically used. The authors did not specify the aetiology (benign vs malignant) or the level of obstruction in their patients. Complications were more frequent in PTBD patients and were mainly non-biliary related, possibly indicating that sicker patients underwent interventions. These confounding factors should be considered before concluding that PTBD is less effective than ERCP for severe cholangitis. The outcome was based solely on the resolution of cholangitis; including the normalisation of bilirubin levels would have been more informative.
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