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首页> 外文期刊>Acta Radiologica >Clinical outcomes after percutaneous biliary interventions in patients with malignant biliary obstruction caused by metastatic gastric cancer
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Clinical outcomes after percutaneous biliary interventions in patients with malignant biliary obstruction caused by metastatic gastric cancer

机译：转移性胃癌致恶性胆道梗阻患者经皮胆道干预后的临床结局

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Background: No report has appeared on the histologic characteristics as influencing factors associated with clinical outcomes and survival of patients who underwent percutaneous biliary interventions to treat malignant biliary obstruction caused by metastatic gastric cancer. Purpose: To investigate the clinical outcomes after percutaneous biliary interventions in patients with malignant biliary obstruction caused by metastatic gastric cancer and to identify prognostic factors associated with clinical outcomes. Material and Methods: We retrospectively assessed 117 patients who underwent percutaneous transhepatic biliary drainage (PTBD) between January 2005 and December 2009, for treatment of malignant biliary obstructions caused by metastatic gastric cancer. Of these 117 patients, 54 subsequently underwent metallic stent placement. Results: The technical success rates of PTBD and metallic stent placement were 100% and 100%, respectively. Self-limiting hemobilia after PTBD occurred in eight (7%) patients, and self-limiting hemobilia (n = 4) and acute pancreatitis (n = 3) after stent placement occurred in seven (13%) patients. Successful drainage was achieved in 105 (90%) of the 117 patients who underwent PTBD and in 49 (91%) of 54 patients who underwent metallic stent placement. Multiple Cox's regression analysis showed that the histology of primary gastric cancer (P = 0.011), serum bilirubin after PTBD (P = 0.002) and stenting (P = 0.017), and chemotherapy after PTBD (P < 0.001) and stenting (P = 0.033) were independent predictors of survival. Conclusion: PTBD and subsequent metallic stent placement were safe and effective methods for palliative treatment in patients with malignant biliary obstruction caused by metastatic gastric cancer. Patients with a differentiated histology of primary gastric cancer and serum bilirubin level ≤2 mg/dl after PTBD are probably the best candidates for treatment with a combination of metallic stent placement and chemotherapy.
机译：背景：尚无组织学特征作为与临床结局和生存率相关的影响因素的报道，这些患者接受经皮胆道干预治疗转移性胃癌引起的恶性胆道梗阻患者。目的：探讨经皮胆道介入治疗转移性胃癌所致恶性胆道梗阻患者的临床结局，并确定与临床结局相关的预后因素。资料和方法：我们回顾性评估了2005年1月至2009年12月间经皮经肝穿刺胆道引流术（PTBD）的117例患者，以治疗由转移性胃癌引起的恶性胆道梗阻。在这117名患者中，有54名随后接受了金属支架置入术。结果：PTBD和金属支架置入的技术成功率分别为100％和100％。八（7％）例患者发生PTBD后发生自限性胆道出血，七（13％）例患者发生自限性胆道出血（n = 4）和急性胰腺炎（n = 3）。接受PTBD的117例患者中有105例（90％）成功引流，接受金属支架置入的54例中49例（91％）成功引流。多重Cox回归分析显示，原发性胃癌的组织学（P = 0.011），PTBD后的血清胆红素（P = 0.002）和支架置入（P = 0.017），PTBD后的化疗（P <0.001）和支架置入（P = 0.033） ）是生存的独立预测因子。结论：PTBD及其后置入金属支架是治疗转移性胃癌所致恶性胆道梗阻的安全有效方法。 PTBD后原发性胃癌组织学差异明显且血清胆红素水平≤2mg / dl的患者可能是金属支架置入和化学疗法相结合的最佳治疗方案。

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