Role of percutaneous transhepatic biliary drainage in patients with obstructive jaundice caused by local recurrence of gastric cancer.
OBJECTIVE
We reviewed the medical records of patients with obstructive jaundice caused by the local recurrence of gastric cancer to clarify the role of percutaneous transhepatic biliary drainage (PTBD).


METHODS
Eleven patients with a mean age of 60.1 years (range: 51-71 years) underwent PTBD because of obstructive jaundice caused by the extrahepatic recurrence of gastric cancer.


RESULTS
Jaundice was relieved in all the patients, and the serum total bilirubin (T-bil) level decreased from 12.2 to 2.1 mg/dL. No major complications associated with the execution of PTBD occurred. Although various symptoms caused by jaundice, such as anorexia, itching, nausea, abdominal pain, and fever, were relieved in all the patients within one week after PTBD, general fatigue persisted in 3 patients and abdominal fullness persisted in one. Seven of the 11 patients were discharged from the hospital after the execution of PTBD and remained at home for a median of 93 days. The median survival time (MST) of the remaining 4 patients who could not be discharged was 48 days. Chemotherapy was added in 5 patients after the execution of PTBD; these patients exhibited a significantly longer MST of 247 days, compared to 62 days among the patients who did not receive chemotherapy (P=0.0176).


CONCLUSIONS
PTBD was safely conducted and improved the quality-of-life of patients with obstructive jaundice caused by the local recurrence of gastric cancer. Furthermore, the use of chemotherapy after PTBD might prolong patient survival although RCT (randomized controlled trial) study should be performed to assess the precise effect of chemotherapy after PTBD.
Department of Surgery, Osaka National Hospital, Chuo-ku, Osaka, Japan.
Tomoki
T
Makino
Kazumasa
K
Fujitani
Toshimasa
T
Tsujinaka
Motohiro
M
Hirao
Masaki
M
Kashiwazaki
Shoji
S
Nakamori
Masakazu
M
Ikenaga
Hideyuki
H
Mishima
Norikazu
N
Masuda
Toshiro
T
Sawamura
D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications* / Q000401:mortality; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000401:mortality