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Article: Choice of palliation for malignant hilar biliary obstruction

TitleChoice of palliation for malignant hilar biliary obstruction
Authors
Issue Date1992
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
American Journal Of Surgery, 1992, v. 163 n. 2, p. 208-212 How to Cite?
AbstractClinical data from 50 consecutive patients with unresectable hilar tumors situated at or proximal to the common hepatic duct were retrospectively analyzed to aid in the selection of appropriate palliative measures. Thirty- four patients had cholangio-enteric bypass (CEB) to either left (28 patients), right (3 patients), or both (3 patients) intrahepatic ductal systems. Sixteen patients had nonoperative drainage (NOD) established either endoscopically (4 patients), percutaneously (9 patients), or using a combined endoscopic-percutaneous approach (3 patients). When compared with patients with CEB, patients with NOD had more frequent medical problems (p <0.03) and lower serum albumin levels on admission (p <0.03). While comparable postprocedural complications (13 CEB patients versus 4 NOD patients) were observed, patients with NOD had a significantly higher hospital mortality (9 CEB patients versus 9 NOD patients, p <0.05). Excluding the 12 patients (6 CEB patients versus 6 NOD patients) who died within 30 days after drainage, the quality of survival of the remaining 38 patients was analyzed with reference to 6 objective parameters. Although patients with NOD had significantly more frequent admissions relating to their catheters (p <0.02), there was no qualitative difference in the survival rate between the two groups of patients. For selected high-risk patients with limited life expectancy, NOD should be offered. However, additional prospective studies are required to decide the best choice of palliation for patients who are not at such high risk.
Persistent Identifierhttp://hdl.handle.net/10722/172683
ISSN
2015 Impact Factor: 2.403
2015 SCImago Journal Rankings: 1.286
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorLo, CYen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-10-30T06:24:15Z-
dc.date.available2012-10-30T06:24:15Z-
dc.date.issued1992en_HK
dc.identifier.citationAmerican Journal Of Surgery, 1992, v. 163 n. 2, p. 208-212en_HK
dc.identifier.issn0002-9610en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172683-
dc.description.abstractClinical data from 50 consecutive patients with unresectable hilar tumors situated at or proximal to the common hepatic duct were retrospectively analyzed to aid in the selection of appropriate palliative measures. Thirty- four patients had cholangio-enteric bypass (CEB) to either left (28 patients), right (3 patients), or both (3 patients) intrahepatic ductal systems. Sixteen patients had nonoperative drainage (NOD) established either endoscopically (4 patients), percutaneously (9 patients), or using a combined endoscopic-percutaneous approach (3 patients). When compared with patients with CEB, patients with NOD had more frequent medical problems (p <0.03) and lower serum albumin levels on admission (p <0.03). While comparable postprocedural complications (13 CEB patients versus 4 NOD patients) were observed, patients with NOD had a significantly higher hospital mortality (9 CEB patients versus 9 NOD patients, p <0.05). Excluding the 12 patients (6 CEB patients versus 6 NOD patients) who died within 30 days after drainage, the quality of survival of the remaining 38 patients was analyzed with reference to 6 objective parameters. Although patients with NOD had significantly more frequent admissions relating to their catheters (p <0.02), there was no qualitative difference in the survival rate between the two groups of patients. For selected high-risk patients with limited life expectancy, NOD should be offered. However, additional prospective studies are required to decide the best choice of palliation for patients who are not at such high risk.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurgen_HK
dc.relation.ispartofAmerican Journal of Surgeryen_HK
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBiliary Tract Neoplasms - Complications - Mortalityen_US
dc.subject.meshCholedochostomyen_US
dc.subject.meshCholestasis - Etiology - Surgeryen_US
dc.subject.meshDrainageen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPalliative Careen_US
dc.subject.meshPancreatic Neoplasms - Complicationsen_US
dc.subject.meshPostoperative Complicationsen_US
dc.titleChoice of palliation for malignant hilar biliary obstructionen_HK
dc.typeArticleen_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/0002-9610(92)90102-Wen_HK
dc.identifier.pmid1371206en_HK
dc.identifier.scopuseid_2-s2.0-0027075891en_HK
dc.identifier.volume163en_HK
dc.identifier.issue2en_HK
dc.identifier.spage208en_HK
dc.identifier.epage212en_HK
dc.identifier.isiWOS:A1992HE19100004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridLo, CY=16417392800en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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