[Prognostic factors of mortality in the malignant biliary obstruction unresectable after the insertion of an endoscopic stent].
OBJECTIVE
To determine the factors prognostics of early mortality in the malignant billary estenosis after the endoscopic derivation.


BACKGROUND
The surgical, percutaneous or endoscopic derivation is the alternative of palliative treatment in the biliary obstruction unresectable. The factors prognostic the early mortality after surgical derivation are: hemoglobin < 10 g/dL, serum bilirubin > 10 mg/dL and serum albumin < 2.5 g/dL; for the percutaneous derivation they are the sanguineous urea more of 4.3 mmol/L and hemoglobin < 10.9 g/dL; whereas in the single endoscopic derivation type 3 of Bismuth and the infectious complications after the endoscopic colangiography and the absence of the clinical success were factors prognoses of early mortality.


METHODS
Descriptive and retrospective analysis of 97 cases with malignant biliary obstruction. The factors were evaluated prognoses of early mortality. Univariated and bivaried analysis and of survival by the method of Kaplan-Meier was made curved.


RESULTS
97 cases were included that presented/displayed unresectable disease and had a biochemical control subsequent to the drainage. They were 58 women and 39 men. More frequent symptoms: ictericia, pain and prurito. 61 cases of distal obstruction and 36 with proximal obstruction. Twenty deaths (25.9%) happened within the 30 later days to the treatment. The bilirubin > 14 mg/dL and the proximal location were like predicting of early mortality.


CONCLUSIONS
The obstruction biliary more frequent is located in choledocho distal and is of pancreatic origin. The main factors associated to early mortality are: the bilirubin > of 14 mg/dL and the proximal location reason why is important the suitable selection of patient candidates to endoscopic derivation. The survival is better in the distal obstruction.
Hernández Guerrero
Angélica
A
Servicio de Endoscopia del Instituto Nacional de Cancerología, Universidad Nacional Autónoma de México.
Sánchez del Monte
Julio
J
Sobrino Cossío
Sergio
S
Alonso Lárraga
Octavio
O
Delgado de la Cruz
Lourdes
L
Frías Mendívil
M Mauricio
MM
Frías Mendívil
C Mauricio
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D001774:Blood Chemical Analysis; D002758:Cholangiography; D001651:Cholestasis, Extrahepatic / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis