The Clinical Benefit of Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Tract Obstruction

被引:9
作者
Nikolic, Ivan [1 ,2 ]
Radic, Jelena [1 ,2 ]
Petres, Andrej [3 ]
Djuric, Aleksandar [1 ]
Protic, Mladjan [1 ,2 ]
Litavski, Jelena [1 ]
Popovic, Maja [1 ,2 ]
Kolarov-Bjelobrk, Ivana [1 ,2 ]
Dragin, Sasa [4 ]
Popovic, Lazar [1 ,2 ]
机构
[1] Oncol Inst Vojvodina, Dept Med Oncol, Put Doktora Goldmana 4, Sremska Kamenica 21204, Serbia
[2] Univ Novi Sad, Fac Med Novi Sad, Hajduk Veljkova 3, Novi Sad 21000, Serbia
[3] Clin Ctr Vojvodina, Dept Radiol, Hajduk Veljkova 1-9, Novi Sad 21000, Serbia
[4] Univ Novi Sad, Fac Agr, Dept Anim Sci, Novi Sad 21000, Serbia
关键词
biliary drainage; jaundice; malignant obstruction; adequate bilirubin decline (ABD); METASTATIC COLORECTAL-CANCER; JAUNDICE; OUTCOMES; RESECTION; CHOLANGIOCARCINOMA; DECOMPRESSION; CHOLANGITIS; SURVIVAL; STENTS;
D O I
10.3390/cancers14194673
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Percutaneous transhepatic biliary drainage (PTBD) has been widely employed as a biliary decompression procedure for malignant proximal biliary obstruction. Patients underwent PTBD procedures of jaundice caused by malignant disease for restarting chemotherapy or palliative intent. Clinical outcomes following PTBD procedure in the two groups of patients, according to the adequate bilirubin decline (ABD) needed to restart chemotherapy, are presented in this analysis. Median survival time following the PTBD was 9 weeks, but in patients with ABD who received chemotherapy it was 64 weeks. Patients with the longest survival rate were in good performance status (ECOG 0-1) and lower bilirubin (<120 mu mol/L) and LDH (<300 mu mol/L) levels at the time of the procedures. Improving quality of life is a major goal in this palliative treatment, but we really need to assess the potential benefits and risks and determine how to select patients who would have positive outcome for this procedure. Percutaneous transhepatic biliary drainage (PTBD) is a decompression procedure for malignant proximal biliary obstruction. In this research, over a six-year period, 89 patients underwent PTBD procedure for jaundice caused by malignant disease to restart chemotherapy or for palliative intent. Clinical outcomes after PTBD procedure in the two groups of patients, according to the adequate bilirubin decline (ABD) needed for subsequent chemotherapy, are presented in this paper. Survival and logistic regression were plotted and compared using Kaplan-Meier survival multivariate analysis with a long-range test. Results were processed by MEDCALC software. In the series, 58.4% (52/89) of patients were in good performance status (ECOG 0/1), and PTBD was performed with the intention to (re)start chemotherapy. The normalization of the bilirubin level was seen in 23.0% (12/52), but only 15.4% (8/52) received chemotherapy. The median survival time after PTBD was 9 weeks. In patients with ABD that received chemotherapy, the median survival time was 64 weeks, with 30-day mortality of 27.7%, and 6.4% of death within 7 days. The best outcome was in patients with good performance status (ECOG 0-1), low bilirubin (<120 mu mol/L) and LDH (<300 mu mol/L) levels and elevated leukocytes at the time of the procedures. PTBD is considered in ABD patients who are candidates for chemotherapy.
引用
收藏
页数:12
相关论文
共 40 条
[1]   Malignant biliary obstructions: can we predict immediate postprocedural cholangitis after percutaneous biliary drainage? [J].
Ahn, Shin ;
Lee, Yoon-Seon ;
Lim, Kyung Soo ;
Lee, Jae-Lyun .
SUPPORTIVE CARE IN CANCER, 2013, 21 (08) :2321-2326
[2]   Preoperative Biliary Drainage in Patients with Resectable Perihilar Cholangiocarcinoma: Is Percutaneous Transhepatic Biliary Drainage Safer and More Effective than Endoscopic Biliary Drainage? A Meta-Analysis [J].
Al Mahjoub, Aimen ;
Menahem, Benjamin ;
Fohlen, Audrey ;
Dupont, Benoit ;
Alves, Arnaud ;
Launoy, Guy ;
Lubrano, Jean .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2017, 28 (04) :576-582
[3]   Endoscopic biliary drainage for malignant distal biliary obstruction: Which is better - endoscopic retrograde cholangiopancreatography or endoscopic ultrasound? [J].
Bang, Ji Young ;
Hawes, Robert ;
Varadarajulu, Shyam .
DIGESTIVE ENDOSCOPY, 2022, 34 (02) :317-324
[4]   Effect of Endoscopic Stenting of Malignant Bile Duct Obstruction on Quality of Life [J].
Barkay, Olga ;
Mosler, Patrick ;
Schmitt, Colleen M. ;
Lehman, Glen A. ;
Frakes, James T. ;
Johanson, John F. ;
Qaseem, Tahir ;
Howell, Douglas A. ;
Sherman, Stuart .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2013, 47 (06) :526-531
[5]   Palliative endoscopic drainage of malignant stenosis of biliary confluence: Efficiency of multiple drainage approach to drain a maximum of liver segments [J].
Caillol, Fabrice ;
Bories, Erwan ;
Zemmour, Christophe ;
Pesenti, Christian ;
Ratone, Jean Philippe ;
Gilabert, Marine ;
Launay, Simon ;
Giovannini, Marc .
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL, 2019, 7 (01) :52-59
[6]   Biliary drainage for obstructive jaundice caused by unresectable hepatocellular carcinoma: the endoscopic versus percutaneous approach [J].
Choi, Jongkyoung ;
Ryu, Ji Kon ;
Lee, Sang Hyub ;
Ahn, Dong-Won ;
Hwang, Jin-Hyeok ;
Kim, Yong-Tae ;
Yoon, Yong Bum ;
Han, Joon Koo .
HEPATOBILIARY & PANCREATIC DISEASES INTERNATIONAL, 2012, 11 (06) :636-642
[7]   Malignant Biliary Tract Obstruction: Evaluation and Therapy [J].
Chu, David ;
Adler, Douglas G. .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2010, 8 (09) :1033-1043
[8]  
Garcarek J, 2012, ADV CLIN EXP MED, V21, P621
[9]   Clinical outcomes after percutaneous biliary interventions in patients with malignant biliary obstruction caused by metastatic gastric cancer [J].
Gwon, Dong Il ;
Ko, Gi-Young ;
Sung, Kyu-Bo ;
Yoon, Hyun-Ki ;
Kim, Kyung-Ah ;
Kim, Young Jun ;
Kim, Tae Hwan ;
Lee, Woong Hee .
ACTA RADIOLOGICA, 2012, 53 (04) :422-429
[10]  
Henson DE, 2009, ARCH PATHOL LAB MED, V133, P67, DOI 10.1043/1543-2165-133.1.67