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[Neoplastic obstructive jaundice: palliative treatment with self-expandable metallic prosthesis]
A Aldeano1, C Sanz, J Figueras
1Servicio de Cirugía General y Digestiva, Ciudad Sanitaria y Universitaria de Bellvitge, L'Hospitalet de Llobregat, Barcelona.
Purpose:
Study of the effectiveness and morbidity of palliative treatment of malignant obstructive jaundice with metallic biliary endoprosthesis compared to surgical palliation.
Design:
Retrospective review.
Patients:
35 patients with non-resectable neoplasms causing jaundice were treated with percutaneous stent (pancreatic carcinoma, n = 11; cholangiocarcinoma, n = 11; gallbladder carcinoma, n = 4; extrahepatic metastases of various malignancies, n = 8).
Control Group:
23 patients with malignant jaundice treated with palliative surgery.
Results:
Most frequent complications were cholangitis and stent obstruction. The mean hospital stay after the stent placement was 6.8 days, longer in patients with complications (p = 0.035). Recurrence of jaundice was seen in 22.9% of the patients and the rate of readmission was 42.9%. The mean survival was 163.33 days (range 19-522). Reduction in serum bilirubin after BE was significant (215 vs. 82 mmol/l, p < 0.001).
Conclusions:
Comparing to our previous experience with surgical palliative treatment, there was no significant difference neither in morbidity-mortality, nor recurrence or readmission. Patients with pancreatic cancer and cholangiocarcinoma benefit from a shorter hospital stay.