Nikolić Ivan, Radić Jelena, Petreš Andrej, Djurić Aleksandar, Protić Mladjan, Litavski Jelena, Popović Maja, Kolarov-Bjelobrk Ivana, Dragin Saša, Popović Lazar
Oncology Institute of Vojvodina, Department of Medical Oncology, Put Doktora Goldmana 4, 21204 Sremska Kamenica, Serbia.
Faculty of Medicine Novi Sad, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia.
Cancers (Basel). 2022 Sep 26;14(19):4673. doi: 10.3390/cancers14194673.
Percutaneous transhepatic biliary drainage (PTBD) is a decompression procedure for malignant proximal biliary obstruction. In this research, over a six-year period, 89 patients underwent PTBD procedure for jaundice caused by malignant disease to restart chemotherapy or for palliative intent. Clinical outcomes after PTBD procedure in the two groups of patients, according to the adequate bilirubin decline (ABD) needed for subsequent chemotherapy, are presented in this paper. Survival and logistic regression were plotted and compared using Kaplan−Meier survival multivariate analysis with a long-range test. Results were processed by MEDCALC software. In the series, 58.4% (52/89) of patients were in good performance status (ECOG 0/1), and PTBD was performed with the intention to (re)start chemotherapy. The normalization of the bilirubin level was seen in 23.0% (12/52), but only 15.4% (8/52) received chemotherapy. The median survival time after PTBD was 9 weeks. In patients with ABD that received chemotherapy, the median survival time was 64 weeks, with 30-day mortality of 27.7%, and 6.4% of death within 7 days. The best outcome was in patients with good performance status (ECOG 0−1), low bilirubin (<120 µmol/L) and LDH (<300 µmol/L) levels and elevated leukocytes at the time of the procedures. PTBD is considered in ABD patients who are candidates for chemotherapy.
经皮经肝胆道引流术（PTBD）是一种用于恶性近端胆道梗阻的减压手术。在本研究中，在六年期间，89例患者因恶性疾病导致的黄疸接受了PTBD手术，目的是重新开始化疗或用于姑息治疗。本文介绍了根据后续化疗所需的充分胆红素下降（ABD）情况，两组患者PTBD术后的临床结果。使用Kaplan-Meier生存多变量分析和长程检验绘制并比较生存曲线和逻辑回归。结果由MEDCALC软件处理。在该系列中，58.4%（52/89）的患者身体状况良好（ECOG 0/1），PTBD的实施目的是（重新）开始化疗。23.0%（12/52）的患者胆红素水平恢复正常，但只有15.4%（8/52）的患者接受了化疗。PTBD术后的中位生存时间为9周。在接受化疗的ABD患者中，中位生存时间为64周，30天死亡率为27.7%，7天内死亡率为6.4%。最佳结果出现在身体状况良好（ECOG 0-1）、胆红素水平低（<120 µmol/L）、乳酸脱氢酶（LDH）水平低（<300 µmol/L）且手术时白细胞升高的患者中。对于适合化疗的ABD患者，可考虑进行PTBD。
