[Survival of patients with malignant biliary stricture based on endoscopic brushing and on bilirubinemia].
BACKGROUND
Pancreatic cancer and cholangiocarcinoma are the main causes of malignant biliary stricture. Both types of cancers have dismal survival rates, and treatment has little or no effect on prolonging the patients lives. Prognostic definition at initial endoscopic retrograde cholangiopancreatography is important to choose the most suitable management.


OBJECTIVE
To analyse endoscopic brushing and bilirubinemia importance in determination of the survival of patients with malignant biliary stricture.


METHODS
Patients with biliary strictures diagnosed during endoscopic retrograde cholangiopancreatography were submitted to double brushing cytology. Serum samples were taken from all patients for bilirubinemia assay. Patients were followed to determine the final diagnosis and survival rates.


RESULTS
A total of 50 patients with biliary stricture underwent endoscopic retrograde cholangiopancreatography (40 ultimately found to have a final diagnosis of malignant disease). Hyperbilirubinemia or cytology brushing positive for malignancy was related to a shorter survival rate.


CONCLUSIONS
This research data demonstrate the possibility of determining the prognosis of patients with malignant biliary stricture using endoscopic brushing results and bilirubinemia levels.
Ornellas
Laura Cotta
LC
Departamento de Medicina, Universidade Federal de São Paulo (UNESP), São Paulo, SP. lauraornellas@hotmail.com
Santos
Gilda da Cunha
Gda C
Libera
Ermelindo Della
ED
Cury
Marcelo de Souza
Mde S
Ferrari
Angelo Paulo
AP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000097:blood / Q000150:complications* / Q000401:mortality; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000209:etiology* / Q000401:mortality; D003251:Constriction, Pathologic / Q000209:etiology; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood / Q000150:complications* / Q000401:mortality; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate