Pancreatic head carcinoma, ampulloma, cholangiocarcinoma, gall bladder cancer, and less often — metastatic lymph nodes lead to malignant extrahepatic biliary obstruction (MEBO). Endoscopic biliary drainage (EBD) of extrahepatic ducts (ED) including stent placement has priority in cholestasis resolving.

Objective. To evaluate the effectiveness of EBD in case of MEBO.

Materials and methods. The outcome of managing 45 patients with MEBO treated with EBD were analyzed retrospectively.

Results. Ampulloma was the cause of MEBO in nine cases, EBD was effective in all of them. Of 24 patients with distal MEBO, EBD was effective in 18 persons. In proximal MEBO, EBD was successful in six of 12 patients.

Conclusions. Endoscopic biliary drainage was successful in 75% cases of malignant biliary obstruction. In case of oncologic process stage IV, EBD was successful in 72.2% (n=13) of patients. The EBD failed due to inability of performing ERCP and getting through the obstruction. Such patients require percutaneous drainage or surgery.