Document Detail


Outcomes in lymphoma patients with obstructive jaundice: a cancer center experience.
MedLine Citation:
PMID:  20632106     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Little information is available to guide clinicians on the optimal approach to managing obstructive jaundice in lymphoma patients.
AIMS: The aim of this study was to review our experience in treating lymphoma patients with obstructive jaundice in order to develop guidelines as to the best interventional approach.
METHODS: We reviewed the medical records of all lymphoma patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous biliary drainage (PBD) for obstructive jaundice between June 2002 and October 2008.
RESULTS: We identified 35 lymphoma patients who underwent ERCP and/or PBD for obstructive jaundice. The mean age was 57.6 years. Most patients (66%) had diffuse large B-cell lymphoma. Stents were placed by ERCP in 25 patients and PBD in nine. Serum bilirubin levels normalized following ERCP or PBD in 29 of 33 (85%) patients with stricture. Stricture resolution occurred in 12 cases. Patients who had obstructive jaundice at the time of their lymphoma diagnosis had significantly longer mean overall survival following intervention than patients in whom obstructive jaundice developed later in the course of their disease (21.3 months vs. 4.5 months, P = 0.0001).
CONCLUSIONS: ERCP and/or PBD effectively normalized serum bilirubin levels. Plastic stents should be used in patients who have obstructive jaundice at the time of lymphoma diagnosis because these strictures tend to resolve before stent exchanges are necessary. For patients in whom obstructive jaundice develops later in the course of their disease, the limited prognosis often makes a single intervention with insertion of a plastic stent sufficient to provide adequate biliary decompression.
Authors:
William A Ross; Chukwuma I Egwim; Michael J Wallace; Michael Wang; David C Madoff; Jeffrey H Lee
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Publication Detail:
Type:  Journal Article     Date:  2010-07-15
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  55     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-16     Revised Date:  2010-11-23    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3271-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA. wross@mdanderson.org
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MeSH Terms
Descriptor/Qualifier:
Bile Ducts, Extrahepatic / pathology
Cholangiopancreatography, Endoscopic Retrograde
Comorbidity
Constriction, Pathologic
Decompression, Surgical
Female
Humans
Jaundice, Obstructive / epidemiology*,  therapy*
Lymphoma, Large B-Cell, Diffuse / epidemiology*
Male
Middle Aged
Retrospective Studies
Stents
Treatment Outcome
Comments/Corrections
Comment In:
Dig Dis Sci. 2010 Dec;55(12):3636   [PMID:  20824500 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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