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Volume 15
Issue 1
10.3390/jcm15010169
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Current Perspectives on Endoscopic Nasobiliary Drainage: Optimizing Patient Management and Preventing Complications

by
Angelica Toppeta
1,*,
Mattia Corradi
1,2,
Beatrice Mantia
1,2,
Adelaide Randazzo
1,
Mario Schettino
1,
Stefania De Lisi
1,
Stefania Carmagnola
1 and
Raffaele Salerno
1
1
Diagnostic and Operative Endoscopy Unit, Azienda Socio Sanitaria Territoriale Fatebenefratelli Sacco Hospital, 20157 Milan, Italy
2
Department of Gastroenterology, Università degli studi di Milano, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 169; https://doi.org/10.3390/jcm15010169 (registering DOI)
Submission received: 12 November 2025 / Revised: 16 December 2025 / Accepted: 23 December 2025 / Published: 25 December 2025
(This article belongs to the Special Issue Advances in Diagnosis and Management of Pancreatobiliary Disorders—2nd Edition)
Review Reports Versions Notes

Abstract

Endoscopic nasobiliary drainage (ENBD) is a well-established technique for biliary decompression in both benign and malignant conditions. Over the past decades, its role has been extensively evaluated in comparison with endoscopic biliary stenting and percutaneous transhepatic biliary drainage. ENBD provides distinct clinical advantages, including real-time monitoring of bile output, the possibility to perform irrigation, and the ability to collect bile samples for cytological analysis. However, it also presents specific challenges such as patient discomfort, tube dislodgement, and the need for careful maintenance. This narrative review synthesizes current evidence from randomized controlled trials, retrospective cohorts, systematic reviews, and meta-analyses, highlighting the main indications, technical innovations, comparative outcomes with alternative drainage techniques, and strategies to prevent complications. Furthermore, it discusses emerging approaches aimed at improving patient tolerance, procedural efficiency, and environmental sustainability, offering an updated framework for optimizing patient management in both benign and malignant biliary obstruction.
Keywords: endoscopic nasobiliary drainage (ENBD); endoscopic retrograde cholangiopancreatography (ERCP); endoscopic biliary stenting (EBS); percutaneous transhepatic biliary drainage (PTBD); malignant biliary obstruction endoscopic nasobiliary drainage (ENBD); endoscopic retrograde cholangiopancreatography (ERCP); endoscopic biliary stenting (EBS); percutaneous transhepatic biliary drainage (PTBD); malignant biliary obstruction

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MDPI and ACS Style

Toppeta, A.; Corradi, M.; Mantia, B.; Randazzo, A.; Schettino, M.; De Lisi, S.; Carmagnola, S.; Salerno, R. Current Perspectives on Endoscopic Nasobiliary Drainage: Optimizing Patient Management and Preventing Complications. J. Clin. Med. 2026, 15, 169. https://doi.org/10.3390/jcm15010169

AMA Style

Toppeta A, Corradi M, Mantia B, Randazzo A, Schettino M, De Lisi S, Carmagnola S, Salerno R. Current Perspectives on Endoscopic Nasobiliary Drainage: Optimizing Patient Management and Preventing Complications. Journal of Clinical Medicine. 2026; 15(1):169. https://doi.org/10.3390/jcm15010169

Chicago/Turabian Style

Toppeta, Angelica, Mattia Corradi, Beatrice Mantia, Adelaide Randazzo, Mario Schettino, Stefania De Lisi, Stefania Carmagnola, and Raffaele Salerno. 2026. "Current Perspectives on Endoscopic Nasobiliary Drainage: Optimizing Patient Management and Preventing Complications" Journal of Clinical Medicine 15, no. 1: 169. https://doi.org/10.3390/jcm15010169

APA Style

Toppeta, A., Corradi, M., Mantia, B., Randazzo, A., Schettino, M., De Lisi, S., Carmagnola, S., & Salerno, R. (2026). Current Perspectives on Endoscopic Nasobiliary Drainage: Optimizing Patient Management and Preventing Complications. Journal of Clinical Medicine, 15(1), 169. https://doi.org/10.3390/jcm15010169

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