title: Prognostic value of inflammation-based markers in patients with recurrent malignant obstructive jaundice treated by reimplantation of biliary metal stents: A retrospective observational study.
abstract: We aimed to assess the therapeutic effect of reimplantation of biliary metal stents by percutaneous transhepatic cholangial drainage (PTCD) in patients with recurrent malignant obstructive jaundice (MOJ). Furthermore, we explored the prognostic value of inflammation-based markers in these patients.We reviewed 33 cases of recurrent MOJ after implantation of biliary metal stents by PTCD, all of which underwent reimplantation of stents under digital subtraction angiography guidance. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin were compared between before and after reimplantation (1 week, 1 month, and 3 months postoperatively). Preoperative clinical data were collected to calculate the inflammation-based markers, including systemic immune-inflammation index (SII, neutrophil × platelets/ lymphocyte), platelets-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR). The primary outcome was overall survival (OS), which was estimated by the Kaplan-Meier method and Cox regression analysis.The levels of ALT, AST, total bilirubin, and direct bilirubin significantly reduced after the reimplantation operation. During a median follow-up time of 10 months, 18 (54.5%) patients died. Gender, albumin, SII, PLR, NLR, and MLR were found to be associated with OS by the log-rank test and univariate analysis. Multivariate Cox analysis identified elevated levels of SII and PLR as significant factors for predicting poor OS.Reimplantation is clinically feasible in patients with recurrent MOJ after implantation of biliary metal stents. SII and PLR are independent, useful inflammation-based prognostic models for predicting outcomes in these patients.
authors.affiliation: Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Jin
authors.forename: Qing
authors.initials: Q
authors.lastname: Pang
authors.forename: Huichun
authors.initials: H
authors.lastname: Liu
authors.forename: Zongkuang
authors.initials: Z
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Yimin
authors.initials: Y
authors.lastname: Lu
authors.forename: Lei
authors.initials: L
authors.lastname: Zhou
authors.forename: Hongtao
authors.initials: H
authors.lastname: Pan
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications; D001662:Biliary Tract Surgical Procedures; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D018281:Cholangiocarcinoma / Q000150:complications; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000097:blood* / Q000209:etiology / Q000401:mortality / Q000601:surgery; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents
chemical_list: D015415:Biomarkers