title: Effect of endoscopic stenting of malignant bile duct obstruction on quality of life.
abstract: OBJECTIVE
  Endoscopic stent insertion is considered the method of choice for palliation of malignant bile duct obstruction (MBDO). However, it can cause complications and requires periodic stent exchanges. Although endoscopic stenting is clearly indicated for relief of cholangitis or refractory pruritus, its role in patients with jaundice alone is less clear. Endoscopic stenting for this relative indication might be justified, if there is a significant improvement in quality of life (QOL) of such patients. The aim of our study was to determine whether endoscopic stenting for MBDO results in improved QOL.
  
  
  METHODS
  Patients undergoing endoscopic retrograde cholangiopancreatography for MBDO and participating in a randomized trial comparing patency duration of 10 and 11.5-Fr biliary plastic stents, completed the Functional Assessment of Cancer Therapy-General questionnaire at baseline, at 1 month after stent insertion, and at 180 days after stent insertion.
  
  
  RESULTS
  A total of 164 patients answered the QOL questionnaire at baseline, 95 patients answered the questionnaire at 30 days, and 54 patients answered the questionnaire at 180 days after stent insertion. Endoscopic biliary stenting resulted in a statistically significant improvement in overall score of QOL, and different aspects of QOL such as physical, emotional, and functional well-being. There was a statistically significant improvement in most of the symptoms specific for MBDO at 30 and 180 days after stenting.
  
  
  CONCLUSIONS
  Endoscopic stenting significantly improves QOL in patients with MBDO, and, therefore, is an appropriate part of palliative treatment in this patient population.
authors.affiliation: Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. olgab@tasmc.health.gov.il
authors.forename: Olga
authors.initials: O
authors.lastname: Barkay
authors.forename: Patrick
authors.initials: P
authors.lastname: Mosler
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Schmitt
authors.forename: Glen A
authors.initials: GA
authors.lastname: Lehman
authors.forename: James T
authors.initials: JT
authors.lastname: Frakes
authors.forename: John F
authors.initials: JF
authors.lastname: Johanson
authors.forename: Tahir
authors.initials: T
authors.lastname: Qaseem
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Howell
authors.forename: Stuart
authors.initials: S
authors.lastname: Sherman
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000209:etiology / Q000601:surgery*; D004384:Duodenoscopy; D006801:Humans; D010190:Pancreatic Neoplasms / Q000150:complications; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods*; D011788:Quality of Life; D015607:Stents; D011795:Surveys and Questionnaires