Symptom relief and quality of life after stenting for malignant bile duct obstruction.

Ballinger, Anne; McHugh, M.; Catnach, S.; Alstead, E. M.; Clark, Michael

doi:10.1136/gut.35.4.467

Cited by 251 publications

(122 citation statements)

References 18 publications

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“…There are several reports that have showed biliary drainage for these patients not only eliminates their physical symptoms but also improves their mental health and social function, resulting in better QOL. According to these results, it is thought that the relief of jaundice should be conducted for patients with obstructive jaundice due to unresectable cancers as a matter of course [97][98][99]. Recently, patients with unresectable or recurrent bile tract cancers often receive chemotherapy.…”

Section: Cq14: Is Biliary Drainage Recommended For Patients With Unrementioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

237

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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Section: Cq14: Is Biliary Drainage Recommended For Patients With Unrementioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

237

165

View full text Add to dashboard Cite

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“…Decompression of malignant biliary obstruction can be crucial for preventing acute cholangitis with accompanied sepsis, symptomatic relief of hyperbilirubinemia-associated pruritus (1), and in some cases, can facilitate a patient's access to further chemotherapy (2,3). However, this patient population may be prone to intrinsic liver dysfunction related to extensive hepatic parenchyma replacement with tumoral tissue or hepatotoxic chemotherapies, which can also result in hyperbilirubinemia (4).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous biliary drainage catheter insertion in patients with extensive hepatic metastatic tumor burden

Langman¹,

Suhocki²,

Hurwitz³

et al. 2016

J. Gastrointest. Oncol.

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Laboratory data before and after PBD insertion were compared. Survival and outcomes analysis performed.A subanalysis was performed on patients with CT-demonstrated catheter traversal of tumoral tissue.Results: A PBD catheter was successfully inserted in all patients. The mean serum bilirubin level decreased significantly from 10.9±6.4 mg/dL immediately prior to PBD insertion to 7.1±5.6 mg/dL (P<0.001) within one month post PBD insertion. Four patients (11%) demonstrated normalization of bilirubin levels to less than 1.6 mg/dL. Of the 14 patients with a post-procedure CT or MRI, the PBD catheter traversed a tumor in 11 (79%). One of these patients required a transfusion after the procedure and one had recurrent catheter exchanges due to pericatheter leakage. The 30-day overall survival was 41% with a median survival of 19 days.The percentage decrease in serum bilirubin after PBD insertion and pre-procedure international normalized ratio (INR) were correlated with improved survival (OR =3.7, P=0.010 and OR =4.9, P=0.028 respectively).The PBD-associated major complication rate was 16%. Conclusions:In patients with hyperbilirubinemia and extensive hepatic metastatic disease burden, survival was dismal after PBD catheter insertion. Serum bilirubin level normalization occurred rarely.

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“…In unresectable patients, obstructive jaundice is routinely managed by endoscopic placement of plastic or metal biliary stents [10]. In addition to the relief of jaundice and pruritus, biliary decompression has been shown to improve quality of life by increasing appetite and reducing indigestion [11,12].…”

Section: Endoscopic Stenting Of Biliary and Pancreatic Obstructionmentioning

confidence: 99%

Metastatic Pancreatic Cancer 2008: Is the Glass Less Empty?

2008

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Pancreatic cancer is the fourth most common cause of adult cancer death in the U.S. The high mortality rate from pancreatic cancer is a result of the high incidence of metastatic disease at the time of diagnosis, an often fulminant clinical course, and the lack of adequate systemic therapies. Unfortunately, only 5%-25% of patients present with tumors amenable to resection. The median diseasefree survival interval following resection for operable pancreatic cancer is 13.4 months for patients treated with adjuvant gemcitabine and 6.9 months for untreated patients. A much higher percentage of patients present with metastatic disease (40%-45%) or locally advanced disease (40%), and have median survival times of 3-6 months or 8 -12 months, respectively. The frustrating lack of significant clinical advancements in the treatment of metastatic pancreatic cancer remains one of medical oncology's biggest disappointments. The past decade-long frustration has resulted in regulators, investigators, and practicing oncologists gradually lowering their standards/expectations with regard to interpreting clinical trials. Two of the more important examples of this include the approval of gemcitabine plus erlotinib and the use of a progressionfree survival advantage to defend the use of gemcitabine plus oxaliplatin. Given the marginal benefit of systemic antineoplastics, a scholarly review inclusive of other palliative strategies will help oncologists optimize the care of pancreatic cancer patients. This article examines the existing evidence in support of a role for palliative therapy in metastatic pancreatic cancer, describes recent developments with newer chemotherapeutic and molecular-targeted agents, and explores future study designs. The Oncologist 2008;13:562-576

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Symptom relief and quality of life after stenting for malignant bile duct obstruction.

Abstract: tion not only relieves jaundice and pruritus in these patients but also improves other symptoms and quality of life. The considerable improvement in appetite after stenting was of particular benefit.

Cited by 251 publications

References 18 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Percutaneous biliary drainage catheter insertion in patients with extensive hepatic metastatic tumor burden

Metastatic Pancreatic Cancer 2008: Is the Glass Less Empty?

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Symptom relief and quality of life after stenting for malignant bile duct obstruction.

Abstract: tion not only relieves jaundice and pruritus in these patients but also improves other symptoms and quality of life. The considerable improvement in appetite after stenting was of particular benefit.

Cited by 251 publications

References 18 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Percutaneous biliary drainage catheter insertion in patients with extensive hepatic metastatic tumor burden

Metastatic Pancreatic Cancer 2008: Is the Glass Less Empty?

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Product

Resources

About

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition