Endoscopic palliation and survival in malignant biliary obstruction

Area of Science:

• Gastroenterology
• Oncology
• Palliative Care

Background:

• Malignant biliary obstruction presents a significant clinical challenge with a generally poor prognosis.
• Management often focuses on palliative care, aiming to improve quality of life and alleviate symptoms.

Purpose of the Study:

• To evaluate the survival rates of patients with malignant biliary obstruction undergoing palliative endoscopic biliary stenting.
• To identify potential predictors of survival in this patient cohort.

Main Methods:

• Retrospective longitudinal study of 182 consecutive patients with malignant biliary obstruction.
• Primary endpoint: date of death or confirmed survival of at least 23 months.
• Data collected included diagnosis, blood indices prior to ERCP, and follow-up status.

Main Results:

• Survival data for at least 23 months was obtained for 181 out of 182 patients (99.5%).
• 37 out of 181 patients (20.4%) survived for more than one year.
• Increased age at the time of the first endoscopic retrograde cholangiopancreatography (ERCP) was significantly associated with increased survival (P < 0.05).
• Histological confirmation of malignancy was obtained in 25.8% of subjects.

Conclusions:

• Palliative endoscopic biliary stenting in malignant biliary obstruction can lead to a one-year survival rate of 20.4%.
• Older age at diagnosis emerged as the sole significant predictor of improved survival in this palliative setting.