Prospective study of outcomes after percutaneous biliary drainage for malignant biliary obstruction Journal Article


Authors: Robson, P. C. ; Heffernan, N.; Gonen, M.; Thornton, R.; Brody, L. A.; Holmes, R.; Brown, K. T.; Covey, A. M.; Fleischer, D.; Getrajdman, G. I.; Jarnagin, W.; Sofocleous, C.; Blumgart, L.; D'Angelica, M.
Article Title: Prospective study of outcomes after percutaneous biliary drainage for malignant biliary obstruction
Abstract: Background: Percutaneous biliary drainage (PBD) is used to relieve malignant bile duct obstruction (MBO) when endoscopic drainage is not feasible. Little is known about the effects of PBD on the quality of life (QoL) in patients with MBO. The aim of this study was to evaluate changes in QoL and pruritus after PBD and to explore the variables that impact these changes. Materials and Methods: Eligible patients reported their QoL and pruritus before and after PBD using the Functional Assessment of Cancer Therapy-Hepatobiliary instrument (FACT-HS) and the Visual Analog Scale for Pruritus (VASP). Instruments were completed preprocedure and at 1 and 4 weeks following PBD. Results: A total of 109 (60 male/49 female) patients enrolled; 102 (94%) had unresectable disease. PBD was technically successful (hepatic ducts cannulated at the conclusion of procedure) in all patients. There were 2 procedure-related deaths. All-cause mortality was 10% (N = 11) at 4 weeks and 28% (N = 31) at 8 weeks post-PBD with a median survival of 4.74 months. The mean FACT-HS scores declined significantly (P < .01) over time (101.3, 94.8, 94.7 at baseline, 1 week, 4 weeks, respectively). The VASP scores showed significant improvement at 1 week with continued improvement at 4 weeks (P < .01). Conclusions: PBD improves pruritus but not QoL in patients with MBO and advanced malignancy. There is high early mortality in this population. © 2010 Society of Surgical Oncology.
Keywords: adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; young adult; major clinical study; clinical trial; mortality; pancreatic neoplasms; outcome assessment; follow-up studies; prospective study; prospective studies; palliative care; quality of life; pain; bleeding; creatinine; creatinine blood level; colorectal carcinoma; fever; pruritus; colorectal neoplasms; bilirubin; hypotension; rigor; longitudinal studies; thrombosis; bile leakage; pancreas adenocarcinoma; sepsis; surgical mortality; bile duct carcinoma; bile duct neoplasms; cholangiocarcinoma; bile duct obstruction; gallbladder carcinoma; gallbladder neoplasms; biliary tract drainage; visual analog scale; bilirubin blood level; chronic kidney failure; drainage; longitudinal study; cholestasis; infectious complication; abscess; catheter complication; septic shock; hemobilia
Journal Title: Annals of Surgical Oncology
Volume: 17
Issue: 9
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2010-09-01
Start Page: 2303
End Page: 2311
Language: English
DOI: 10.1245/s10434-010-1045-9
PUBMED: 20358300
PROVIDER: scopus
PMCID: PMC4435845
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Leslie H Blumgart
    346 Blumgart
  2. Mithat Gonen
    727 Gonen
  3. Anne Covey
    122 Covey
  4. William R Jarnagin
    604 Jarnagin
  5. Lynn Brody
    95 Brody
  6. Karen T Brown
    165 Brown
  7. Piera M Cote Robson
    6 Robson
  8. Russell Holmes
    4 Holmes