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Identifying predictive markers for survival in malignant biliary obstruction following percutaneous transhepatic biliary drainage

  • 0University Hospital Southampton, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
Clinical Radiology +

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January 28, 2025

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January 28, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Patient survival after percutaneous transhepatic biliary drainage (PTBD) for malignant biliary obstruction depends on several factors. Age, cancer type, and pre-procedure hemoglobin and bilirubin levels significantly impact outcomes.

Area Of Science

  • Hepatobiliary and Pancreatic Surgery
  • Interventional Radiology
  • Oncology

Background

  • Malignant biliary obstruction is frequently managed with percutaneous transhepatic biliary drainage (PTBD).
  • Patient outcomes after PTBD show significant variability, often attributed to diverse underlying etiologies and disease severity.
  • Current evaluation of PTBD outcomes often groups patients collectively, potentially masking prognostic differences.

Purpose Of The Study

  • To investigate whether patient and disease factors explain the variability in survival outcomes following PTBD for malignant biliary obstruction.
  • To identify independent predictors of survival in patients undergoing PTBD.

Main Methods

  • Retrospective analysis of 156 patients undergoing first-time malignant PTBD between 2017-2021.
  • Survival data censored as of June 2022.
  • Univariate (Kaplan-Meier, log-rank test) and multivariate (Cox regression) analyses were performed using aetiology, age, preprocedural hemoglobin, and bilirubin as predictors.

Main Results

  • Median overall survival for the cohort was 136 days.
  • Underlying aetiology significantly impacted survival, with non-hepatobiliary cancers having the worst prognosis (53 days) compared to cholangiocarcinoma (347 days).
  • Independent predictors of worse survival included age > 70 years, preprocedural hemoglobin < 110 g/dL, and bilirubin > 232 µmol/L.

Conclusions

  • Age, malignant aetiology, preprocedural hemoglobin, and bilirubin levels are independent prognosticators of survival after PTBD.
  • These factors should be considered when evaluating patients for PTBD.
  • Careful patient selection based on these predictors may optimize outcomes following PTBD.