Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 103431
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.103431
Enhancing palliative care in malignant obstructive jaundice: A critical care perspective on endoscopic biliary stenting
Yun Xie, Hui Xie, Rui-Lan Wang
Yun Xie, Hui Xie, Rui-Lan Wang, Intensive Care Unit, Shanghai General Hospital, Shanghai 201600, China
Co-corresponding authors: Hui Xie and Rui-Lan Wang.
Author contributions: Xie Y was responsible for methodology, formal analysis, writing - original draft; Xie H and Wang RL were responsible for conceptualization, methodology, supervision, writing - review & editing; Xie H and Wang RL contribute equally to this study as co-corresponding authors.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui-Lan Wang, Intensive Care Unit, Shanghai General Hospital, No. 650 New Song Jiang Road, Shanghai 201600, China. wangyusun@hotmail.com
Received: November 22, 2024
Revised: January 11, 2025
Accepted: January 21, 2025
Published online: March 27, 2025
Processing time: 94 Days and 13.4 Hours
Abstract

This letter responds to Wang et al's recent publication on endoscopic biliary stenting for malignant obstructive jaundice (MOJ) by offering constructive feedback and suggestions for future research. We commend the authors for their comprehensive study design and execution, which included a clear delineation of study groups and a robust set of outcome measures. We suggest that future studies incorporate additional biomarkers, such as serum levels of liver enzymes and bilirubin, to provide a more nuanced understanding of liver function changes post-intervention. The study's focus on short-term survival rates is appreciated, but we recommend exploring longer-term follow-up periods to capture the full spectrum of survival outcomes. Additionally, the inclusion of quality of life assessments using validated instruments could offer a more holistic view of patient outcomes. From a critical care perspective, we advocate for the integration of advanced imaging techniques to better characterize biliary anatomy and potentially predict treatment response or complications. We believe that incorporating these suggestions could enhance the understanding of endoscopic biliary stenting's role in MOJ management and its impact on patient outcomes, influencing future clinical guidelines and practice.

Keywords: Malignant obstructive jaundice; Endoscopic biliary stenting; Palliative care; Critical care; Liver function; Quality of life

Core Tip: The core tip of the manuscript is to evaluate the efficacy of endoscopic biliary stenting for malignant obstructive jaundice and compare it with the standard palliative approach, percutaneous transhepatic biliary drainage. The study suggests incorporating additional biomarkers for a nuanced understanding of liver function changes and emphasizes the importance of long-term follow-up to assess survival outcomes and the durability of palliative effects. It also highlights the need for quality of life assessments and advanced imaging techniques to predict treatment response and complications, contributing to a more holistic view of patient outcomes.