Malignant Biliary Obstruction: Clinical Outcome of Endoscopic Intervention - An Experience of Tertiary Centers

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Title Malignant Biliary Obstruction: Clinical Outcome of Endoscopic Intervention - An Experience of Tertiary Centers
 
Creator MM Kabir; Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM) Hospital, Dhaka
MA Masud; Dhaka Medical College, Dhaka
MM Rahman; Sahabuddin Medical College, Gulshan, Dhaka
MN Hoque; Department of Gastrointestinal, Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
SM Hossain; Gastroliver Hospital & Research Institute, Dhaka
TM Bhuiyan; Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
MM Alam; Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
MS Arfin; Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
MA Rahman; Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
AQM Mohsen; Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
AKA Khan; Department of Gastrointestinal, Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM Hospital, Dhaka
 
Subject Gastroenterology;
biliary obstruction; endoscopic intervention
 
Description Most patients with malignant obstructive jaundice present at a stage when they are beyond the scope of curative surgery. Endoscopic stenting is the approach of choice worldwide to improve quality of life and survival of such patients. The aim of this study was to find out overall clinical outcome of endoscopic intervention in malignant obstructive jaundice. This prospective study done in two tertiary gastroenterology centers in Dhaka included consecutively admitted 79 adult patients with malignant biliary obstruction for endoscopic stenting, followed by a follow-up period of six months. Outcome evaluation included success rate of stenting and drainage, complications, and mortality rate at one-month, and survival up to six-months. ERCP revealed carcinoma of pancreas, periampullary carcinoma, cholangiocarcinoma, carcinoma of gallbladder, and metastasis in the biliary trees in 22 (27.8%), 22 (27.8%), 20 (25.3%), 11 (13.9%), and 04 (5.1%) cases respectively. Successful stenting and drainage could be achieved in 62 (78.5%) and 58 (73.4%) cases. Stent blockage (23.9%) and cholangitis (19.4%) were the main complications. Total death at one-month was nine of 55 (16.4%), and 21 (38.2%) patients survived up to six-months, with no difference in one-month mortality rate among the malignancies (P>0.05). Stenting prolonged six-month (88.2%) and mean survival (121.2±67.7 days) only in patients with periampullary carcinoma (P<0.001). Endoscopic stenting can safely be done in malignant biliary obstruction to offer palliation with an outcome, which is not unsatisfactory. (J Bangladesh Coll Phys Surg 2006; 24: 61-68)
 
Publisher Bangladesh College of Physicians and Surgeons
 
Date 2007-06-12
 
Type
 
Format application/pdf
 
Identifier http://www.banglajol.info/index.php/JBCPS/article/view/150
 
Source Journal of Bangladesh College of Physicians and Surgeons; Vol 24, No 2 (2006); 61-68
 
Language en
 
Coverage Bangladesh
 
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