[Non-resectable neoplasms of the biliary duct: palliative surgery vs non-surgical management].
A retrospective analysis comparing the results of biliary enteric anastomoses and non-operative management in unresectable bile duct carcinomas was carried out. Twenty-four patients underwent surgical drainage (Group A), and 29 were managed with transhepatic or endoscopic stent (Group B). Concomitant medical diseases were more frequent in group B patients (16.6% vs 48.2%, p < 0.03). Group A and group B were comparable in morbidity (29.1% vs 41.3%), mortality (12.5% vs 13.7%) and 1-year survival rate (21% vs 17%). Median survival was 4.2 months in group A and 2.6 in group B. Jaundice relief was achieved in 70.8% of group A patients and in 68.9% of group B. Group B patients experienced more cholangitis (p = 0.001) and required more hospital readmission (p = 0.0015). Quality of life was better in group A patients, however difference did not reach statistical significance. Therefore, low risk patients with unresectable hilar bile duct tumor and yet good life expectancy may benefit from surgical palliation.
Tocchi
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I Istituto di Clinica Chirurgica, Università degli Studi La Sapienza, Roma.
Costa
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Lepre
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Liotta
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Mazzoni
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Sita
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D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004724:Endoscopy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome