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Effect of Endoscopic Stenting of Malignant Bile Duct Obstruction on Quality of Life.
MedLine Citation:
PMID:  23269313     Owner:  NLM     Status:  Publisher    
BACKGROUND AND GOALS:: Endoscopic stent insertion is considered the method of choice for palliation of malignant bile duct obstruction (MBDO). However, it can cause complications and requires periodic stent exchanges. Although endoscopic stenting is clearly indicated for relief of cholangitis or refractory pruritus, its role in patients with jaundice alone is less clear. Endoscopic stenting for this relative indication might be justified, if there is a significant improvement in quality of life (QOL) of such patients. The aim of our study was to determine whether endoscopic stenting for MBDO results in improved QOL. PATIENTS AND METHODS:: Patients undergoing endoscopic retrograde cholangiopancreatography for MBDO and participating in a randomized trial comparing patency duration of 10 and 11.5-Fr biliary plastic stents, completed the Functional Assessment of Cancer Therapy-General questionnaire at baseline, at 1 month after stent insertion, and at 180 days after stent insertion. RESULTS:: A total of 164 patients answered the QOL questionnaire at baseline, 95 patients answered the questionnaire at 30 days, and 54 patients answered the questionnaire at 180 days after stent insertion. Endoscopic biliary stenting resulted in a statistically significant improvement in overall score of QOL, and different aspects of QOL such as physical, emotional, and functional well-being. There was a statistically significant improvement in most of the symptoms specific for MBDO at 30 and 180 days after stenting. CONCLUSIONS:: Endoscopic stenting significantly improves QOL in patients with MBDO, and, therefore, is an appropriate part of palliative treatment in this patient population.
Olga Barkay; Patrick Mosler; Colleen M Schmitt; Glen A Lehman; James T Frakes; John F Johanson; Tahir Qaseem; Douglas A Howell; Stuart Sherman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-23
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  -     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
*Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel †University of Kentucky Medical Center, Lexington, KY ‡Galen Medical Group, Chattanooga, TN §Indiana University Medical Center, Indianapolis, IN ∥College of Medicine, University of Illinois ¶Rockford Gastroenterology Associates Ltd., Rockford, IL #Presbyterian Healthcare Services, Rio Rancho, NM **Maine Medical Center, Portland, ME.
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