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. 2022 Sep 26;14(19):4673.
doi: 10.3390/cancers14194673.

The Clinical Benefit of Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Tract Obstruction

Ivan Nikolić  1   2 , Jelena Radić  1   2 , Andrej Petreš  3 , Aleksandar Djurić  1 , Mladjan Protić  1   2 , Jelena Litavski  1 , Maja Popović  1   2 , Ivana Kolarov-Bjelobrk  1   2 , Saša Dragin  4 , Lazar Popović  1   2
Affiliations

The Clinical Benefit of Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Tract Obstruction

Ivan Nikolić et al. Cancers (Basel). .

Abstract

Percutaneous transhepatic biliary drainage (PTBD) is a decompression procedure for malignant proximal biliary obstruction. In this research, over a six-year period, 89 patients underwent PTBD procedure for jaundice caused by malignant disease to restart chemotherapy or for palliative intent. Clinical outcomes after PTBD procedure in the two groups of patients, according to the adequate bilirubin decline (ABD) needed for subsequent chemotherapy, are presented in this paper. Survival and logistic regression were plotted and compared using Kaplan−Meier survival multivariate analysis with a long-range test. Results were processed by MEDCALC software. In the series, 58.4% (52/89) of patients were in good performance status (ECOG 0/1), and PTBD was performed with the intention to (re)start chemotherapy. The normalization of the bilirubin level was seen in 23.0% (12/52), but only 15.4% (8/52) received chemotherapy. The median survival time after PTBD was 9 weeks. In patients with ABD that received chemotherapy, the median survival time was 64 weeks, with 30-day mortality of 27.7%, and 6.4% of death within 7 days. The best outcome was in patients with good performance status (ECOG 0−1), low bilirubin (<120 µmol/L) and LDH (<300 µmol/L) levels and elevated leukocytes at the time of the procedures. PTBD is considered in ABD patients who are candidates for chemotherapy.

Keywords: adequate bilirubin decline (ABD); biliary drainage; jaundice; malignant obstruction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Normalized-bilirubin-level patients after PTBD.
Figure 2
Figure 2
Overall survival versus bilirubin cut-off level of 120 µmol/L.
Figure 3
Figure 3
Additional chemotherapy after PTBD.
Figure 4
Figure 4
Overall survival versus ECOG status.
Figure 5
Figure 5
Overall survival of patients with colorectal versus non-colorectal cancer.
Figure 6
Figure 6
Median overall survival rate.
Figure 7
Figure 7
Leukocytes (normal vs. elevated).
Figure 8
Figure 8
LDH level (<300 µmol/L vs. >300 µmol/L).
See this image and copyright information in PMC

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