Prediction of survival following percutaneous biliary drainage for malignant biliary obstruction

Tuqan, Wael; Innabi, Ayoub; Alawneh, Alia; Farsakh, Fadi Abu; Al-Khatib, Maan

doi:10.1515/jtim-2017-0014

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…Pancreatic, gallbladder and bile duct neoplasia are the most common causes of malignant biliary obstruction (MBO) 1 . In cases of advanced unresectable cancer, the prognosis is poor, and a recent study reported a median survival post-biliary drain insertion of 46 days, with 1-, 3-, and 6-month survival rates of 64.7 %, 26.5 %, and 7.4 % respectively 2 . In these cases, biliary decompression with placement of an endoscopic or percutaneous stent is a critical form of palliative treatment.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis

et al. 2019

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Background and aim To assess the rate of adverse events and the technical success rate of biliary stenting with or without EBS. Methods A literature search up to February 2017 was performed. Studies assessing adverse events (AEs) and technical success rates of stenting with or without EBS were considered. Results Seven studies (870 patients; 12 treatment arms) were included. Early AEs, i. e. those occurring within 30 days, were significantly lower in no-EBS vs. EBS-group (11 % vs . 20.1 %; OR: 0.36, 95 %CI: 0.13 – 1.00). Rates of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis were not significantly different in the two groups (no-EBS vs . EBS: 6.1 % vs 5 %; OR: 1.33, 95 %CI: 0.68 – 2.59). The rate of bleeding was significantly lower in patients without EBS (no-EBS vs EBS: 0 % vs 5 %; OR: 0.12, 95 % CI: 0.03 – 0.45). Rates of cholangitis were significantly lower in patients without EBS (no-EBS vs . EBS: 3.3 % vs. 7.4 %; OR: 0.38, 95 %CI: 0.17 – 0.83). Both late AEs and mortality rates did not significantly differ between no-EBS and EBS patients (19.9 % vs. 18.9 %; OR: 0.93, 95 %CI: 0.56 – 1.53, and 2.5 % vs. 2.9 %; OR: 1.18, 95 %CI: 0.22 – 6.29, respectively). The technical success rate for stent insertion also did not differ (98 % vs. 97.6 %; OR: 1.05, 95 %CI: 0.42 – 2.63). Conclusion EBS seems to be associated, in the first 30 days after the procedure, with an increased risk of cholangitis and bleeding. No difference was observed in the rate of post-ERCP pancreatitis.

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Section: Introductionmentioning

confidence: 99%

Endoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis

et al. 2019

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“…Tuqan et al, in their study of 72 patients of MBO who underwent percutaneous biliary drainage observed survival rates of 64% and 27% at 1 month and 3 months, respectively. 15 Rees et al, in their study population of 16822 patients with unresectable MBO reported 7-day and 30-day mortality of 5.2% and 23.1%, respectively, with a median survival of 92 days. 16 The factors favoring survival with statistically significance in our study were younger age and good performance status.…”

Section: Discussionmentioning

confidence: 92%

Retrospective analysis of the efficacy of percutaneous transhepatic biliary drainage in palliation of obstructive jaundice in patients with carcinoma gall bladder: Experience from tertiary care center in Northern India

et al. 2021

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Background: Percutaneous Transhepatic Biliary Drainage (PTBD) is a minimally invasive procedure to palliate the biliary obstruction caused by unresectable malignancy. Aims and Objective: To analyze the outcome of PTBD in patients of unresectable gall bladder cancer presenting with obstructive jaundice in terms of reduction in serum bilirubin levels, symptomatic improvement, and overall survival (OS) at 4 weeks and 12 weeks following the procedure. Materials and Methods: In this retrospective study, PTBD was attempted on 30 patients diagnosed with inoperable gall bladder cancer. Various patient and procedure-related variables were analyzed and recorded both pre and post-PTBD. Outcome data on OS was collected at 4 weeks and 12 weeks. Results: Technical success was achieved in 29 (99.66%) patients. The mean fall in the serum bilirubin at the 7th post-procedural day was 41.5% after the successful PTBD. The most common complication in our study was cholangitis noted in six (21%) patients. OS at 4 weeks and 12 weeks was 79% and 41%, respectively. Conclusion: Younger age and good performance status favored better survival rate in our study.

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“…Available literature suggests that PTBD is a palliative procedure and does not significantly prolong the patient's life, even though improvement in bilirubin levels can be dramatic [12,13,15,16]. Further, a group of patients do become eligible for additional CT [4,15,17].…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of percutaneous transhepatic biliary drainage for malignant biliary tract obstruction—a prospective study comparing external and internal drainage techniques

et al. 2021

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Purpose To evaluate the clinical results of percutaneous transhepatic biliary drainage (PTBD) in patients with non-operable malignant biliary tract obstruction (MBTO) and the survival benefit of internal drainage. Methods Prospective data of consecutive patients of PTBD from May 2014 to August 2017 was analyzed for 30-day, 90-day and 1-year mortality, and mean survival of patients undergoing external drainage (ED) and internal drainage (ID) using internal-external ring biliary catheterization or biliary stent were compared. Other important variables evaluated were drop in the total bilirubin (TBil) levels, improvement in pain and pruritus, procedure-related complications, and patient satisfaction. Results In 87 cases (54 male, 33 female) with mean age 37.3 y (22-70 y; 95% CI: 31.1 y-43.5 y), 10, 45 and 32 patients underwent stenting, external and internal-external catheterization, respectively (total 152 procedures [> 1 in 35.63%, n = 31]). PTBD resulted in decrease in mean TBil by 8.2738 ± 0.912 mg/dL at 30 days (P < 0.001), 55.14% (n = 48) cases reaching 3 mg/dL at mean 45 days, and 35/48 cases received chemotherapy. Overall mortality was 6.89%, 37.93% and 90.80% at 30 days, 90 days and 1 year, respectively. Mean survival with ID (236.40 ± 33.37 days) was better than with ED (110.35 ± 26.16 days) (P < 0.001). Pain (62.06%; n = 54; mean Visual Analog Scale [VAS] score = 6.7) improved significantly (mean VAS score 3.4; P < 0.001). Pruritus (n = 29) was relieved in 100% of the cases. Complication rate of 18.39% (n = 16) and no procedure-related death were seen. Conclusion PTBD offers a safe and significant improvement in TBil, pain, and pruritus in non-operable MBTO, with ID offering additional survival benefit over ED.

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Prediction of survival following percutaneous biliary drainage for malignant biliary obstruction

Cited by 13 publications

References 22 publications

Endoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis

Endoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis

Retrospective analysis of the efficacy of percutaneous transhepatic biliary drainage in palliation of obstructive jaundice in patients with carcinoma gall bladder: Experience from tertiary care center in Northern India

Survival benefit of percutaneous transhepatic biliary drainage for malignant biliary tract obstruction—a prospective study comparing external and internal drainage techniques

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