Prediction of survival following percutaneous biliary drainage for malignant biliary obstruction

Author:

Tuqan Wa’el1,Innabi Ayoub2,Alawneh Alia3,Farsakh Fadi Abu4,Al-Khatib Maan5

Affiliation:

1. Department of Internal Medicine , University of New Mexico School of medicine , Albequerque, New Mexico , USA

2. Department of Internal Medicine , University of Arkansas for Medical Sciences , Arkansas , USA

3. Department of Medical Oncology , Tawam Hospital , Abu Dhabi , United Arab Emirates

4. Department of Medical Oncology , King Hussein Cancer Center , Amman , Jordan

5. Department of Radiology , Tawam Hospital , Abu Dhabi , United Arab Emirates

Abstract

Abstract Background and Objectives Percutaneous transhepatic biliary drain is an intervention used to relieve malignant biliary obstruction. This study aims to explore survival after biliary drain insertion, predictive factors of survival and effectiveness to reduce total bilirubin level. Methods We conducted a retrospective analysis of 72 patients who had malignant biliary obstruction and received biliary drain during the time period between March 2005 and February 2015. Results Median patients’ age was 56 years. 38 (52.7%) were males, 34(47.2%) were females. Median survival post biliary drain insertion was 46 days, 95% C/I (37.92–54.02), range (2–453 days). 1, 3, and 6 month survival rates were 64.7%, 26.5%, and 7.4% respectively. Multivariate analysis by Cox proportional hazards regression model showed the presence of ascites to be significant predictors of survival, other factors analyzed were: total bilirubin, serum creatinine, international normalization ratio, serum albumin, pleural effusion and liver metastasis. Conclusion Survival after biliary drain insertion can vary from few days to few months. Presence of ascites is an independent predictor of survival after this intervention.

Publisher

Walter de Gruyter GmbH

Subject

Internal Medicine

Reference27 articles.

1. Nurick AW, Patey DH, Whiteside CG. Percutaneous transhepatic cholangiography in the diagnosis of obstructive jaundice. Br J Surg 1953; 41: 27-30.

2. Shaldon S, Barber KM, Young WB. Percutaneous transhepatic cholangiography. A modified technique. Gastroenterology 1962; 42: 371-9.

3. Zinberg SS, Berk JE, Plasencia H. Percutaneous transhepatic cholangiography: its use and limitations. Am J Dig Dis 1965; 10: 154-69.

4. Zhong SX. Percutaneous transhepatic cholangiography (PTC) and bile drainage (PTCD): a report of 70 cases (author’s transl). Zhonghua wWai Ke Za Zhi 1981; 19: 387-90.

5. Shimaguchi S, Ariyama J. Value of percutaneous transhepatic cholangiography with drainage and ultrasonography in the treatment of extrahepatic bile duct obstruction. J Belge Radiol 1982; 65: 221-5.

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