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Complications of Biliary Drainage in Patients with Malignant Biliary Obstruction

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Abstract

Purpose

Biliary tract obstruction in cancer patients is usually associated with a poor prognosis. The obstruction may cause distressing symptoms, such as pruritus. As this situation occurs mostly in advanced cancer, the primary objective of the treatment is in many cases symptom control and not prolonging life. However, some patients can be candidates for chemotherapy. To see the outcomes of stenting insertion in patients of our oncology center.

Methods

A retrospective study of patients who have undergone this procedure between 1 October 2011 and 31 December 2018 was carried out.

Results

Insertion of a biliary stent was performed in 171 patients. The most common diagnoses were gastric and colorectal cancers, each with 42 (24%), followed by pancreatic (34 (20%)) and biliary tract cancer (25 (14%)). Most stents (155 (91%)) were placed percutaneously. Complications were seen in 91 (53%) patients and the most common was cholangitis in 48 (53%) patients, and the median survival was 75.5 days (3–1246). A total of 168 (98%) patients were referred to palliative care. In a multivariable analysis, the ECOG performance status was associated with survival, with the ECOG 0, 1, and 2 associated with better survival and peritoneal metastases associated with lower survival.

Conclusions

For many patients with advanced cancers, it may not be clear if the benefits of palliative biliary stents outweigh the risks. Therefore, the problem should be discussed with the patients and their families, making clear the goals of care and the potential benefits and risks that can be expected.

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Acknowledgments

This work was supported in part by the North Section of the Portuguese League against Cancer.

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Authors and Affiliations

  1. Palliative Care Service, Instituto Português de Oncologia, R. Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal

    José António Ferraz Gonçalves, Ana Rita Lopes & Maria José Sousa

  2. Centro Hospitalar e Universitário do Porto, Porto, Portugal

    Eugénia Rosendo

  3. Hospital de Braga, Braga, Portugal

    Luciana Sousa

  4. Centro Hospitalar de Vila Nova de Gaia / Espinho, Espinho, Portugal

    Inês Leão

  5. Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal

    Rita Queirós

  6. Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal

    Sara Marote

Authors
  1. José António Ferraz Gonçalves
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  2. Eugénia Rosendo
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  3. Luciana Sousa
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  4. Ana Rita Lopes
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  5. Inês Leão
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  6. Rita Queirós
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  7. Sara Marote
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  8. Maria José Sousa
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Corresponding author

Correspondence to José António Ferraz Gonçalves.

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The study was approved by the Ethics Committee of the hospital.

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The authors declare that they have no conflict of interest.

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Ferraz Gonçalves, J.A., Rosendo, E., Sousa, L. et al. Complications of Biliary Drainage in Patients with Malignant Biliary Obstruction. J Gastrointest Canc 52, 1067–1072 (2021). https://doi.org/10.1007/s12029-020-00541-6

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  • DOI: https://doi.org/10.1007/s12029-020-00541-6

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