Endoscopic palliation of jaundice in gallbladder cancer.

Endoscopically placed biliary endoprostheses were used to treat obstructive jaundice in 64 patients with advanced or recurrent gallbladder carcinoma. Successful placement of an endoprosthesis was achieved in 55 patients (86%). Bilirubin declined in 52 of 55 cases (94.5%) and normalized in 37 of 44 patients (84%) who survived more than 30 days. Procedure-related mortality was 3.1%. The thirty-day mortality of 14.5% was better, and the mean overall survival of 161 days was comparable to published surgical results. Due to the lower cost, improved patient tolerance, and reasonable survival, we consider endoscopic drainage to be the procedure of choice in patients with obstructive jaundice secondary to recurrent and unresectable gallbladder cancer.