Survival analysis pattern of patients treated with biliary metallic stent versus patients treated with surgical procedures for hepato-biliary malignancies in a rural tertiary care centre in South India

Abstract

Background: Tumors of the biliary tract show spectrum ranging from benign to malignant lesions. Only 20% of tumors are resectable at the time of presentation. The operative mortality was approximately 5 to 20%. The morbidity rate associated with the surgery is approximately 65%. Options for palliative therapy of biliary tree obstruction include the surgical bypass, percutaneous external drainage/stenting and endoscopic stenting. The aim was to compare the survival pattern of patients treated with biliary Self Expandable Metallic Stents (SEMS) as a palliative procedure to that of patients treated by curative surgery.Methods: This was a retrospective study. 6-months survival pattern were analysed in 20 patients treated by SEMS and compared with that of 10 patients treated with plastic biliary stents followed by curative surgery.Results: Survival pattern analysis was done for all 20 patients with SEMS. 7 patients were in >1-year survival, 5 were in >6months survival, 6 expired within 6months, 2 patients were lost to follow up. Survival pattern was compared with 10 patients who had plastic stents followed by curative surgery. Only 1 patient had survival rate >1year post-surgery, 5 patients expired post-surgery in <6months, 2 patients expired few weeks after plastic stent deployment, 2 patients were lost to follow up.Conclusions: In patients with biliary malignancies with obstruction, biliary SEMS followed up by palliative chemotherapy had better survival rate than patients who had plastic stents followed up with curative surgical procedures.