Endoscopic Stent Placement for Obstructive Jaundice Secondary to Metastatic Malignancy

William H. Marsh, John T. Cunningham

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

In patients with malignancy, jaundice may result from hepatic infiltration or metastatic lymph nodal compression along the bile duct. We attempted endoscopic stent placement on 31 consecutive patients with biliary obstruction from malignant adenopathy, with and without computerized tomographic (CT) scan evidence of hepatic parenchymal metastases. Endoscopic or combined endoscopic‐percutaneous decompression was accomplished in 28 patients. Fifteen patients (53.6%) had CT evidence of concomitant metastatic disease to the liver. Thirteen patients had obstructing adenopathy only. Mean survival for patients with hepatic metastases after relief of extrahepatic obstruction was 117.4 days (range 9‐386 days). Mean survival after biliary decompression in patients without hepatic involvement was significantly longer at 364.3 days (range 52‐1098 days; p= 0.0087). Bilirubin levels fell in all patients in this group. No patient died from complications of obstruction or stent placement. Our data support the conclusion that patients with extrahepatic metastatic biliary obstruction without hepatic metastases have improved survival, compared with patients with both obstruction and hepatic involvement. In the absence of hepatic parenchymal involvement, endoscopic stent placement can safely and effectively palliate metastatic extrahepatic obstruction. Controlled trials are needed to assess the effect of such stenting on survival.

Original languageEnglish (US)
Pages (from-to)985-990
Number of pages6
JournalThe American Journal of Gastroenterology
Volume87
Issue number8
DOIs
StatePublished - Aug 1992

    Fingerprint

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this