| Unresectable hilar cholangiocarcinoma: percutaneous versus operative palliation. | |
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MedLine Citation:
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PMID: 7513906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several nonoperative and operative options are available for palliation of patients with unresectable hilar cholangiocarcinoma. This retrospective analysis compares the results of nonoperative percutaneous stenting and operative palliation in 65 patients. METHODS: Twenty-one patients were managed with percutaneous biliary stents (group A), and 44 patients underwent laparotomy (group B) with placement of large-bore silicone rubber transhepatic stents in 33. The two groups were similar with respect to age, gender, mean laboratory data, and cholangiographic extent of tumor. RESULTS: Group A and group B patients were comparable in hospital morbidity (67% vs 61%), hospital mortality (14% vs 7%), and mean initial hospital stay (27 vs 31 days). Survival was greater in group B laparotomy patients at 1, 3, and 6 months (p < 0.01), and median survival was 5 months for group A compared with 8 months for group B patients (p = 0.06). Group A patients who were managed with percutaneous stents required more stent changes per month of survival (0.5 vs 0.3, p = 0.06). However, group B patients who underwent operative palliation were more likely to undergo a second operation (0% vs 21%, p = 0.05), most often for duodenal or small-bowel obstruction. CONCLUSIONS: Operative placement of large-bore transhepatic stents may reduce cholangitis, delay hepatic failure, and prolong survival. We conclude that patients with unresectable hilar cholangiocarcinoma who are fit for surgery may benefit from operative palliation. |
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Authors:
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I H Nordback; H A Pitt; J Coleman; A C Venbrux; W C Dooley; N N Yeu; J L Cameron |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Surgery Volume: 115 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1994 May |
Date Detail:
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Created Date: 1994-06-08 Completed Date: 1994-06-08 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 597-603 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Md. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cholangiocarcinoma / mortality, surgery* Female Follow-Up Studies Humans Liver Neoplasms / mortality, surgery* Male Middle Aged Palliative Care Retrospective Studies Stents Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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