Palliative interventions for patients with malignant obstructive jaundice

Abstract

Patients with obstructive jaundice present the significant medical problem, as a category of advanced patients. Stagnation of bile could lead to the liver failure rapidly. In the department of hepatopancreatobiliary surgery and liver transplantation of Syzganov's NSCS were treated 57 patients (2010–2014) with obstructive jaundice of tumor etiology, in the age of 46 – 82. Causes of jaundice were distributed between pancreatic cancer 29 (50.8%), cancer of the main bile duct 28 (49.1%). Types of biliary decompressive operations: 17 (29.8%) patients underwent percutaneous transhepatic (antegrade) drainage, 37 (64.9%) patients-endoscopic (retrograde) stenting, another 3 (5.2%) patients-combine external-internal draining (“rendezvous” technique). As a result, there were no any mortality associated with percutaneous transhepatic or endobiliary interventions. Complications after endobiliary stenting were observed in 5 (8.7%) cases: the dislocation of stent-2 cases (3.5%); acute pancreatitis-2 cases (3.5%), bleeding-1 case (1.7%). Patients after percutaneous external drainings have hadn't any complications. The use of minimally invasive decompression techniques in obstructive jaundice management is quite effective palliative action, which prevents the development of liver failure, improves the quality and length of life of patients with biliary and pancreatic malignancies. Percutaneous decompressive procedures of biliary tract looks safe and could be recommended for center with small experience.