title: Outcomes in percutaneous stenting of non-hepato-biliary/pancreatic malignant jaundice.
abstract: The aim of this study is to review the practice and outcomes at our institution of percutaneous transhepatic placement of metallic biliary stents for non-hepato-biliary/pancreatic (non-HBP) malignant obstructive jaundice. A retrospective review was performed of the records of all patients undergoing transhepatic stenting for non-HBP malignant obstructive jaundice over a 7-year period. A total of 25 patients were successfully stented and linear regression analysis of a variety of demographic, clinical and laboratory markers against survival was performed. Survival after stenting varied from 1 to 1354 days (median 58, mean 152). An initial bilirubin level less than 300 micromol/L (P=0.01) and a reduction of greater than 50% in bilirubin post stenting (P=0.02) were strong predictors of improved survival. Older patients survived longer than younger ones (P<0.01). There was a weak association of survival with an albumin>30 g/L (P=0.06), but no statistically significant correlation with creatinine or haemoglobin levels or active tumour treatment after stenting. There were few major complications from the procedures. Transhepatic metallic biliary stenting for non-HBP malignant biliary obstruction is a safe and effective procedure, and with careful patient selection, significant periods of survival and palliation of jaundice can be achieved.
authors.affiliation: Department of Radiology, The James Cook University Hospital, Middlesbrough, UK. mellermark@hotmail.com
authors.forename: M T
authors.initials: MT
authors.lastname: Meller
authors.forename: G R J
authors.initials: GR
authors.lastname: Arts
authors.forename: J R
authors.initials: JR
authors.lastname: Dean
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract; D001663:Bilirubin / Q000378:metabolism; D002779:Cholestasis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin