Extrahepatic biliary obstruction secondary to metastatic cancer

Thirty patients with extrahepatic biliary obstruction secondary to metastatic cancer were reviewed to determine the sites of the primary tumor, diagnostic methods, therapy and success of palliation. Colon carcinoma was the most common primary tumor, and the common bile duct was most often obstructed. Both percutaneous transhepatic and surgical decompression of the biliary tract were employed. Twenty-seven (90 percent) of the patients obtained successful palliation. The length of survival averaged 270 +/- 49 days in patients treated surgically compared with 60 +/- 11 days in patients who underwent decompression by radiologic techniques. Mortality was not increased in patients undergoing operative biliary drainage. Surgical decompression may be the best method for managing patients with biliary obstruction secondary to metastatic cancer.