SYMPTOM RELIEF AND QUALITY-OF-LIFE AFTER STENTING FOR MALIGNANT BILE-DUCT OBSTRUCTION

Palliative treatment is appropriate for most patients with cancer of t he head of pancreas. Insertion of a biliary stent relieves jaundice an d pruritus but it is not known if stenting affects other symptoms or c hanges the quality of life. Nineteen patients have completed a standar d questionnaire to assess symptom relief and quality of life after ste nt insertion. After stenting there was complete relief of jaundice and pruritus. Furthermore, there was also considerable improvement in ano rexia and indigestion. All patients had anorexia before stent insertio n, this was moderate/severe in 13 (68-4%). Anorexia was significantly better (p<0.01) a week after stenting and this benefit was maintained at 12 weeks (p<0.01). Sixteen (84.2%) patients complained of indigesti on before stenting, moderate/severe in 11 (57.9%). This was significan tly better (p<0.01) a week after stenting with complete relief in six at eight weeks (p<0.01). Fifteen (78.9%) felt that their mood was good /very good before stent insertion and this was unchanged even at the 1 2 week assessment. A similar result was obtained for physical health a nd level of activity. In conclusion stent insertion not only relieves jaundice and pruritus in these patients but also improves other sympto ms and quality of life. The considerable improvement in appetite after stenting was of particular benefit.