Weaver S A, Stacey B S, Hayward S J, Taylor G J, Rooney N I, Robertson D A
Department of Gastroenterology, Royal United Hospital, Combe Park, Bath, UK.
Dig Dis Sci. 2001 Oct;46(10):2147-53. doi: 10.1023/a:1011950612554.
Malignant biliary obstruction is a common problem that is regarded as having a poor prognosis and is usually managed with palliation. Our aim was to investigate the survival of 182 consecutive subjects with malignant biliary obstruction where management was palliative with an [corrected] endoscopically placed biliary stent. We undertook a retrospective longitudinal study with date of death or confirmed survival of at least 23 months, as the primary end point. Diagnosis and blood indices from the 24 hr prior to first ERCP were obtained from hospital records. Of the 182 eligible subjects follow-up of date of death or confirmed survival of at least 23 months was obtained in 181 (99.5%). Of these 181 patients, 37 (20.4%) survived for more than one year. Histological confirmation was obtained in 47 of 182 subjects (25.8%). Increased age at first ERCP predicted increased survival (P < 0.05). In conclusion, in patients with malignant biliary obstruction, where management was endoscopic and palliative, 20.4% survived for more than one year with increased age at diagnosis being the only significant predictive marker.
恶性胆管梗阻是一个常见问题，其预后较差，通常采用姑息治疗。我们的目的是调查182例连续的恶性胆管梗阻患者的生存情况，这些患者接受了经内镜放置胆管支架的姑息治疗。我们进行了一项回顾性纵向研究，将死亡日期或确诊存活至少23个月作为主要终点。从医院记录中获取首次内镜逆行胰胆管造影（ERCP）前24小时的诊断和血液指标。在182例符合条件的患者中，181例（99.5%）获得了死亡日期或确诊存活至少23个月的随访。在这181例患者中，37例（20.4%）存活超过一年。182例患者中有47例（25.8%）获得了组织学确诊。首次ERCP时年龄增加预示着生存期延长（P<0.05）。总之，在接受内镜姑息治疗的恶性胆管梗阻患者中，20.4%存活超过一年，诊断时年龄增加是唯一显著的预测指标。
