MALIGNANT OBSTRUCTIVE-JAUNDICE - PALLIATI VE TREATMENT WITH EXPANDABLE METALLIC STENTS

Purpose: Study of the effectiveness and morbidity of palliative treatm ent of malignant obstructive jaundice with metallic biliary endoprosth esis compared to surgical palliation. Design: Retrospective review. Pa tients: 35 patients with non-resectable neoplasms causing jaundice wer e treated with percutaneous stent (pancreatic carcinoma, n=11; cholang iocarcinoma, n=11; gallbladder carcinoma, n=4; extrahepatic metastases of various malignancies, n=8). Control group: 23 patients with malign ant jaundice treated with palliative surgery, Results: Most frequent c omplications were cholangitis and stent obstruction. The mean hospital stay after the stent placement was 6.8 days, longer in patients with complications (p=0.035), Recurrence of jaundice was seen in 22.9% of t he patients and the rate of readmission was 42.9%, The mean survival w as 163.33 days (range 19-522). Reduction in serum bilirubin after BE w as significant (215 vs. 82 mmol/l, p<0.001), Conclusions: Comparing to our previous experience with surgical palliative treatment, there was no significant difference neither in morbimortality, nor recurrence o r readmission. Patients with pancreatic cancer and cholangiocarcinoma benefit from a shorter hospital stay.