OUTCOMES IN PATIENTS WITH EXTRAHEPATIC CHOLANGIOCARCINOMA WHO UNDERWENT PALLIATIVE BILIARY DRAINAGE AT SAWANPRACHARAK HOSPITAL
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Date
2009-09-21
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Chiang Mai Medical Journal
Abstract
Objective: The aim of the study was to evaluate the therapeutic results of palliative biliary drainage in patients with extrahepatic cholangiocarcinoma (EHCC) at Sawanpracharak Hospital.
Material and method: A retrospective study of EHCC patients, who were diagnosed by endoscopic cholangiopancreatography (ERCP), was performed between 2000 and 2007. The patients were divided in to 2 groups according to the majority of procedures: “Pre-stenting” group (2000-2003) comprising 29 patients and “Stenting” group (2004-2007) consisting of 92 patients. The efficiency of biliary drainage was evaluated by serum bilirubin and alkaline phosphatase. Remote results of treatment were assessed by mean survival time.
Results: There were 121 patients with EHCC; mean age 65.9 years; location of tumor - 80.2% hilar, 18.2% middle and distal 1.6%. The therapy consisted of endoscopic stenting and surgery. Jaundice was significantly relieved in all patients who underwent biliary drainage (p \< 0.05). There were 3 (21.4%) operative deaths in the “Pre-stenting” group, while no procedure-related complications occurred in the “Stenting” group. There was no significant difference of mean survival time after biliary drainage in either surgical or endoscopic approaches (p \< 0.05).
Conclusion: Most patients with EHCC were Klatskin tumor and presented with advanced stage that was unsuitable for curative surgical resection. Palliation has become the mainstay in management for the relief of biliary obstruction. Endoscopic biliary drainage is an effective procedure for palliating obstructive jaundice without procedure-related mortality or major complications.
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Chiang Mai Medical Journal; Vol.47 No.2 June 2008 (pages 45 - 95); 83 - 88