ENDOSCOPIC AND PERCUTANEOUS INTERVENTION IN MALIGNANT OBSTRUCTIVE-JAUNDICE

Most patients with malignant obstructive jaundice have inoperable dise ase at presentation. There is debate regarding the best approach to pa lliate these patients, i.e., surgical versus endoscopic versus percuta neous drainage. The purpose of this article is to review the current l iterature in an unbiased fashion, and to present a rationale for manag ement. A multi-disciplinary approach is needed if we are to provide th e best care for patients with standardization of definitions, complica tions, and outcomes between specialities such that meaningful comparis ons can be made between studies. The need for prospective randomized t rials is clear from the currently deficient literature.