title: The outcome of cholangitis after percutaneous biliary drainage in neoplastic jaundice.
abstract: The purpose of this paper is to evaluate factors affecting the outcome of cholangitis after PTBD in jaundiced cancer patients. Twenty nine patients with neoplastic jaundice (male/female ratio 13/16, median age 55 years) with full clinical data, were treated by PTBD and developed cholangitis at a median of 9 days later. Four patients (14%) died of biliary sepsis a median of one month after PTBD while the other 25 survived a median of 6 months, with one week median duration of cholangitis. The probability of the cholangitis resolving was analyzed by time to resolution and it was found that 50% and 100% of the recoveries occurred 5 and 9 months respectively from the onset of the complication. The series was analyzed to determine the role of several variables (disease/patient/treatment related) in the resolution of cholangitis. Only a low stricture site, a large initial drainage catheter (10F) and a temperature increase exceeding 39 degrees C were correlated with a positive outcome. We conclude that PTBD-related cholangitis has, in our experience, a good chance of cure, low mortality rate and satisfactory 6 months median survival.
authors.affiliation: Surgical Oncology D, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
authors.forename: R A
authors.initials: RA
authors.lastname: Audisio
authors.forename: C
authors.initials: C
authors.lastname: Morosi
authors.forename: F
authors.initials: F
authors.lastname: Bozzetti
authors.forename: G
authors.initials: G
authors.lastname: Cozzi
authors.forename: M
authors.initials: M
authors.lastname: Bellomi
authors.forename: P
authors.initials: P
authors.lastname: Pisani
authors.forename: A
authors.initials: A
authors.lastname: Pestalozza
authors.forename: L
authors.initials: L
authors.lastname: Gennari
authors.forename: A
authors.initials: A
authors.lastname: Severini
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001646:Bile / Q000382:microbiology; D002404:Catheterization / Q000295:instrumentation; D002761:Cholangitis / Q000209:etiology* / Q000503:physiopathology; D002779:Cholestasis / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome