Rees J, et al. - A retrospective cohort study was conducted to assess the effect of percutaneous transhepatic biliary drainage (PTBD) in malignant biliary obstruction to establish risk factors for poor outcomes. They recruited a total of 16,822 adult individuals undergoing PTBD for palliation of pancreatic-biliary cancer in England between 2001 and 2014 distinguished from Hospital Episode Statistics. They applied multivariate logistic regression analysis to investigate relationships with mortality and the requirement for a repeat PTBD within 2 months. The data showed that 30-day mortality was high at 23.1% in individuals undergoing PTBD for the palliation of malignant biliary obstruction. They found higher mortality in older patients, men, those with increasing comorbidity, a cancer site other than the pancreas and at ‘lower-volume’ PTBD providers.