Sellier F, et al. - The clinicians embraced this study to ascertain the survival after biliary drainage and the associated prognostic factors. This study demonstrated the benefits of biliary drainage for malignant biliary obstruction during the course of chemotherapy for colorectal cancer. A successful biliary drainage caused an improvement in survival and allowed the achievement of chemotherapy for 70% of patients.

• The clinicians retrospectively included patients from 2 French centers after first biliary endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography drainage for biliary obstruction secondary to liver metastases of colorectal cancer, occurring during chemotherapy.

• The clinicians included 69 patients in the final analysis.
• In this study, the overall median survival was 115 days.
• Factors significantly associated with an improved survival were a previous liver surgery, technical and functional success of drainage and restarted chemotherapy, in univariate analysis.
• After a median of 27 days, chemotherapy was restarted.
• Survival improved from 33 to 262 days (p < 0.001) when drainage was efficient.
• In multivariate analysis, previous a hepatectomy (HR 0.41) and functional success of the drainage (HR 0.29) were included as significant protective factors for survival.
• Increased lines of chemotherapy (HR 1.68) and fever before drainage (HR 2.97) were included as predictive factors for death.