A retrospective study comparing endoscopic self-expandable metallic stents with surgery in the treatment of malignant obstructive jaundice
10.3760/cma.j.issn.1007-8118.2012.02.012
- VernacularTitle:内镜置入可膨式金属胆道支架治疗恶性梗阻性黄疸的疗效观察
- Author:
Ying SHI
;
Xiaoxing CHEN
;
Shunfu XU
;
Wenfang CHENG
;
Hong ZHU
- Publication Type:Journal Article
- Keywords:
Malignant obstructive jaundice;
Endoscopic;
Metallic stent;
Operation
- From:
Chinese Journal of Hepatobiliary Surgery
2012;18(2):118-122
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy and survival of patients with malignant obstructive jaundice using either endoscopic self-expandable metallic stents or surgery,and to evaluate the compounding factors influencing prognosis.Methods 56 patients with malignant obstructive jaundice treated with endoscopic self-expandable metallic stents (the endoscopic group) were compared with 90 patients who received surgery (the surgery group) during the same study period.Clinical data and survival of the 2 groups of patients were retrospectively analyzed.Results The success rate was 100％ in the endoscopic group.The serum bilirubin,alkaline phosphatase (ALP) and γ-glutamyl transferase (γ-GT) decreased significantly by using either therapeutic endoscopy or surgery (P＜0.01).There was no significant difference between the two groups in the reduction of serum total bilirubin.The mean survival of the endoscopic and surgery groups were 340 d and 795 d respectively.The accumulative survivals of the endoscopic group at 3,6 and 12 months as evaluated by the Kaplan-Meier method were 82.6 ％,61.1％ and 46.6 ％,respectively,and for the surgery group were 97.0％,90.9 ％ and 65.4％ respectively. There was a significant difference in survival between the two groups (P＜0.01).Survival after therapeutic endoscopy was similar to surgery for patients with metastasis and hilar biliary obstruction.Conclusions Self-expandable metallic stents gave similar palliation in the relief of jaundice in patients with malignant biliary obstruction.The stents had no effect on the primary tumor.Therapeutic endoscopy with self-expandable metallic stents is a safe and effective method for the relief of jaundice in patients with obstructive jaundice caused by non-resectable malignant tumors.
