Outcomes in percutaneous stenting of non-hepato-biliary/pancreatic malignant jaundice

MELLER M.T., ARTS G.R.J. & DEAN J.R. (2010) European Journal of Cancer Care19, 664–668 Outcomes in percutaneous stenting of non‐hepato‐biliary/pancreatic malignant jaundice The aim of this study is to review the practice and outcomes at our institution of percutaneous transhepatic placement of metallic biliary stents for non‐hepato‐biliary/pancreatic (non‐HBP) malignant obstructive jaundice. A retrospective review was performed of the records of all patients undergoing transhepatic stenting for non‐HBP malignant obstructive jaundice over a 7‐year period. A total of 25 patients were successfully stented and linear regression analysis of a variety of demographic, clinical and laboratory markers against survival was performed. Survival after stenting varied from 1 to 1354 days (median 58, mean 152). An initial bilirubin level less than 300 µmol/L (P= 0.01) and a reduction of greater than 50% in bilirubin post stenting (P= 0.02) were strong predictors of improved survival. Older patients survived longer than younger ones (P < 0.01). There was a weak association of survival with an albumin >30 g/L (P= 0.06), but no statistically significant correlation with creatinine or haemoglobin levels or active tumour treatment after stenting. There were few major complications from the procedures. Transhepatic metallic biliary stenting for non‐HBP malignant biliary obstruction is a safe and effective procedure, and with careful patient selection, significant periods of survival and palliation of jaundice can be achieved.