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

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

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. Clinica...

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Bibliographic Details
Published in:Cancers Vol. 14; no. 19; p. 4673
Main Authors: Nikolić, Ivan, Radić, Jelena, Petreš, Andrej, Djurić, Aleksandar, Protić, Mladjan, Litavski, Jelena, Popović, Maja, Kolarov-Bjelobrk, Ivana, Dragin, Saša, Popović, Lazar
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 26-09-2022
MDPI
Subjects:
Bile ducts
Biliary tract
Biliary tract diseases
Bilirubin
Cancer therapies
Care and treatment
Chemotherapy
Cholangiocarcinoma
Cholangitis
Colorectal cancer
Decompression
Drainage, Surgical
Endoscopy
Jaundice
Laboratories
Leukocytes
Liver cancer
Medical prognosis
Metastasis
Methods
Mortality
Multivariate analysis
Oncology
Pancreatitis
Patient outcomes
Patients
Pruritus
Quality of life
Survival analysis
Tumors
Wound drainage
Serbia
adequate bilirubin decline (ABD)
malignant obstruction
jaundice
biliary drainage
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Summary: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 µmol/L) and LDH (<300 µmol/L) levels and elevated leukocytes at the time of the procedures. PTBD is considered in ABD patients who are candidates for chemotherapy.
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ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14194673