Palliation of malignant biliary obstruction: A prospective trial examining impact on quality of life

摘要: Background: Endoscopic decompression is used for palliation of patients with malignant biliary obstruction. Little known its effect on quality life. The aims this study were to determine clinical characteristics that have the greatest adverse impact life in obstruction, and quantify changes obstruction after successful a plastic stent. Methods: Patients without liver metastases considered nonsurgical candidates referred tertiary university medical center palliative endoscopic sequentially enrolled prospective cohort study. SF-36 Health Survey questionnaire at baseline 1 month stent insertion was Results correlated laboratory parameters. Multivariate analyses carried out independent predictors improvement insertion. Results: Fifty (20 men, 30 women; mean [SD] age 72.6 [10.6] years) weight 62.4 (12.9) kg body mass index 23.4 (4.3) kg/m2 enrolled. Two thirds had distal lesion, 12.5% mid bile duct rest either hilar or intrahepatic cholangiocarcinoma. At baseline, 70% complained pruritus 98% jaundiced (mean total bilirubin 15 [7] mg/dL). Mean duration symptoms before 23 (25) days. Weight loss, elevated level domains both univariate multivariate analysis. After drainage, complete follow-up information available 51% initial cohort. Among these 26 patients, 33% documented 84% associated significant improvements social function (relative risk = 0.11; 95% CI [0.03, 0.19]) mental health 0.036; [0.011, 0.08]). A greater than 14 mg/dL lack 1-month (p 0.03). Conclusions: loss hyperbilirubinemia are strongly predictive poor decompression. Successful drainage life, although less true among over 13 mg/dL. These results may lead better selection require validation. (Gastrointest Endosc 2002;56:835-41.)