• Prospective Study of outcomes after percutaneous biliary drainage for malignant biliary obstruction【1】
• Pruritus improved by PBD
• No improvement in QoL scores
1. Robson et al Ann Surg Oncol 2010; 17 :2303-11
• High technical success rate
• Effective relief of some symptoms particularly pruritus
• 30 day mortality significant
– Consider appropriate patient selection
– Consider potential surgery or chemotherapy
BSIR Biliary Register【2】：
• 833 patients, 62 Radiologists, 44 Hospitals
• Aetiology of obstruction –malignant in 88%
– 42.2% pancreatic adenocarcinoma
• 98.7% technical success rate
• Bilirubin reduction 88.5%
• Partial / complete symptom relief 65%
– bilirubin下降 < 50% -29% complete relief
- bilirubin下降 > 50% -57% complete relief
• In hospital mortality 19.8%
• 1 Year survival < 20%
• Mortality rates
–5 xhigher than open AAA repair
–10 xcardiac surgery
Expected Survival【2】
• Pancreatic adenocarcinoma
– Locally advanced 6 –10 months
– Metastatic3 –6 months
• Cholangiocarcinoma< 12 months
• Gall bladder cancer6 months
• Intra-hepatic metastases
Success Rates
•Reported series > 50 patients
•Technical success rates > 95%
•Clinical success rates 60 –80%
2. Uberoiet al CVIR online Feb 2011 |