Clinical evaluation of endoscopic biliary stenting in treatment of malignant obstructive jaundice.

Abstract

Background: Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.

Aim: To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.

Methods: The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed. According to the treatment method, the patients were divided into an observation group (29 patients) and a control group (30 patients). General data, liver function indices, complications, adverse effects, and 3-year survival rates after different surgical treatments were recorded for the two groups.

Results: There were no significant differences in baseline information (sex, age, tumor type, or tumor diameter) between the two groups (P > 0.05). Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels were significantly better in both groups after surgery than before surgery (P < 0.05). The overall incidence of biliary bleeding, gastrointestinal bleeding, pancreatitis, and cholangitis was 6.9% in the observation group and 30% in the control group (P < 0.05). No significant differences in the rates of blood transfusion, intensive care unit admission, or death within 3 years were observed between the two groups at the 1-month follow-up (P > 0.05). The 3-year survival rates were 46.06% and 39.71% in the observation and control groups, respectively.

Conclusion: Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function, with minimal complications. This technique is a promising palliative approach for patients ineligible for radical surgery. However, further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.