title: Long-term risk of cholangitis in patients with metal stents for malignant biliary obstruction.
abstract: BACKGROUND
  Patients with malignant biliary obstruction are commonly living longer than previously due to improved oncologic therapies, often exceeding expected times of self-expanding metal stent patency.
  
  
  OBJECTIVE
  The purpose of this study was to assess the long-term risk and impact of cholangitis in these patients.
  
  
  METHODS
  Retrospective review of electronic medical records at an academic medical center.
  
  
  RESULTS
  One hundred and one patients had a self-expanding metal stent placed for malignant biliary obstruction. The median survival after SEMS was 214 days. Of these patients, 22 % developed at least one episode of cholangitis requiring inpatient admission, 20 % (9/45) of patients were hospitalized for cholangitis at 6 months, 40 % (8/20) at 1 year, and 75 % (3/4) at 2 years. All of the (8/8) patients receiving chemotherapy prior to hospitalization for cholangitis experienced delays in subsequent chemotherapy. Follow-up of 36 episodes of cholangitis revealed a 14 % 30-day mortality.
  
  
  CONCLUSIONS
  Cholangitis develops commonly in long-term survivors with self-expanding metal stents for malignant biliary obstruction, and is associated with delays in chemotherapy and a 14 % 30-day mortality.
authors.affiliation: Division of Gastroenterology, UC San Diego Health System, 9500 Gilman Drive MC 0063, San Diego, CA 92093-0063, USA. spola@ucsd.edu
authors.forename: Suresh
authors.initials: S
authors.lastname: Pola
authors.forename: Ramya
authors.initials: R
authors.lastname: Muralimohan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cohen
authors.forename: Syed M Abbas
authors.initials: SM
authors.lastname: Fehmi
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Savides
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000628:therapy*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000628:therapy; D002761:Cholangitis / Q000209:etiology* / Q000401:mortality / Q000473:pathology*; D003251:Constriction, Pathologic / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors