Biliopancreatic tumors: patient survival and quality of life after palliative treatment

Rev Esp Enferm Dig. 2004 May;96(5):305-14. doi: 10.4321/s1130-01082004000500003.
[Article in English, Spanish]

Abstract

Objectives: to analyse survival and quality of life of patients with malignant obstructive jaundice after palliative treatment, comparing endoscopic stent insertion and palliative surgical (palliative resection and bypass surgical).

Patients and method: eighty and seven patients were included in a trial. They were distributed to endoscopic stent (50) and palliative surgical (37). It analysed survival, quality of life and comfort index of jaundiced patients. The good quality of life was defined by absence of jaundice, pruritus and cholangitis after the initial treatment.

Results: the median survival of the patients treated to endoscopic stent was 9,6 months whereas the patients to surgical treatment survived a median of 17 months. The time free of disease was 4 months in stented patients and 10,5 months in surgical patients. There was no significant difference in comfort index between the two groups (stented 34%, surgical 42,5%) Neither was there significant difference in survival and quality of life between palliative resection and bypass surgery.

Conclusions: despite the survival and time free of disease being better in surgical patients, there was no significant difference in overall quality of life between the two groups. The survival and quality of life are the same after palliative resection as after bypass surgery, for this should not be performed routinely or to justify resection as a debulking procedure.

MeSH terms

  • Aged
  • Bile Duct Neoplasms / complications
  • Bile Duct Neoplasms / surgery*
  • Biliopancreatic Diversion*
  • Endoscopy, Digestive System
  • Female
  • Humans
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / surgery*
  • Male
  • Middle Aged
  • Palliative Care*
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / surgery*
  • Quality of Life*
  • Retrospective Studies
  • Stents*
  • Survival Analysis