Extrahepatic biliary obstruction by metastatic gastric carcinoma

Kent Man Chu, Simon Law, Frank Branicki, John Wong

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

Forty-one patients with extrahepatic biliary obstruction by metastatic gastric carcinoma underwent retrospective study to determine demographics, clinical features, laboratory findings on presentation, time interval from previous gastrectomy, level of biliary obstruction, methods of palliation, complications from treatment, treatment results, and survival. Thirty-seven patients underwent biliary decompression by percutaneous transhepatic biliary drainage (PTBD) (35 patients), endoscopic insertion of plastic stent (one patient), and operative insertion of T tube (1 patient). The remaining 4 patients had no biliary drainage procedure performed. Subsequently expandable metallic biliary stents were inserted in 9 patients through the PTBD tract. Two patients received postdrainage external irradiation. Reduction in serum total bilirubin was seen in all patients after drainage. Two patients were alive at the time of this analysis. The median survival of these 41 patients was only 70 days. The 6- and 9-month survival rates were 27.0% and 9.7%, respectively. Hemoglobin (p < 0.001) and total bilirubin (p < 0.002) on presentation were found to be independent factors predicting survival. Extrahepatic biliary obstruction by metastatic gastric carcinoma was associated with poor survival. Patients with profound anemia or jaundice on presentation carried the worst prognosis.

Original languageEnglish
Pages (from-to)63-66
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume27
Issue number1
DOIs
Publication statusPublished - 1998
Externally publishedYes

Keywords

  • Biliary obstruction
  • Gastric carcinoma

ASJC Scopus subject areas

  • Gastroenterology

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