Endoscopic stenting in obstructive jaundice due to liver metastases: does it have a benefit for the patient?

The goal of this report is to describe our experience with the palliative endoscopic treatment of jaundice occurring in the setting of liver and hilar metastases of a distant primary malignancy.

We retrospectively analyzed the clinical course of 29 consecutive patients with metastatic tumors not originating in the hepatobiliopancreatic area, who were treated by endoscopic retrograde cholangiopancreatography with endoprostheses insertion.

We achieved a complete follow-up in 24 out of the 29 patients (11 women, median age 69 years). The primary tumor site was the colorectum in 15 patients, stomach in 4, lung in 2, breast and prostate in 1 and one patient had a lymphoma. The median bilirubinemia before therapy was 16 (1.8-31) mg/dl and the median minimum serum bilirubin reached after stenting was 2.6 (0.3-11.5) mg/dl. Stent dysfunction was observed in 33.5% of the patients and stent change was necessary 13 times. The median survival after therapy was 4 (2.5-19) months for patients with colon tumors and 3 (0.5-12) months in patients with other cancers. An improvement in the quality of life was obtained in 75% of the patients after endoscopic treatment.

Endoscopic stenting should be attempted even on patients with obstructive jaundice due to liver metastases.