Publication:

Survival analysis pattern of patients treated with biliary metallic stent versus patients treated with surgical procedures for hepato-biliary malignancies in a rural tertiary care centre in South India

Background Tumors of the biliary tract show spectrum ranging from benign to malignant lesions.  Only 20% of tumors are resectable at the time of presentation.  The operative mortality was approximately 5 to 20%. The morbidity rate associated with the surgery is approximately 65%. Options for palliative therapy of biliary tree obstruction include the surgical bypass, percutaneous external drainage/stenting and endoscopic stenting. The aim was to compare the survival pattern of patients treated with biliary Self Expandable Metallic Stents (SEMS) as a palliative procedure to that of patients treated by curative surgery.

Methods This was a retrospective study. 6-months survival pattern were analysed in 20 patients treated by SEMS and compared with that of 10 patients treated with plastic biliary stents followed by curative surgery.

Results Survival pattern analysis was done for all 20 patients with SEMS. 7 patients were in >1-year survival, 5 were in >6months survival, 6 expired within 6months, 2 patients were lost to follow up. Survival pattern was compared with 10 patients who had plastic stents followed by curative surgery. Only 1 patient had survival rate >1year post-surgery, 5 patients expired post-surgery in <6months, 2 patients expired few weeks after plastic stent deployment, 2 patients were lost to follow up.

Conclusions In patients with biliary malignancies with obstruction, biliary SEMS followed up by palliative chemotherapy had better survival rate than patients who had plastic stents followed up with curative surgical procedures.