Timing of Cholangitis and Percutaneous Transhepatic Biliary Drainage

By: Amanda E. Ruffino, BA
Posted: Thursday, June 1, 2023

Hannu Syrjälä, MD, PhD, of Oulu University Hospital, Finland, and colleagues sought to evaluate the impact of cholangitis on the survival of patients with gastrointestinal cancer and malignant biliary obstruction treated with percutaneous transhepatic biliary drainage. Their findings, which indicated poorer survival if cholangitis occurred before rather than after percutaneous transhepatic biliary drainage, were published in BMC Gastroenterology.

The study included 588 patients; 43.9% had pancreatic cancer, 37.7% had biliary tract cancer, and 18.4% had metastasis from gastrointestinal cancers. The investigators found that patients with cholangitis before percutaneous transhepatic biliary drainage had a higher 30-day mortality rate (30.8%) than did patients with cholangitis after the procedure (19.5%) and patients without cholangitis (25.8%). Furthermore, the median survival was shorter for patients with cholangitis before percutaneous transhepatic biliary drainage (1.8 months) compared with patients with cholangitis after the procedure (3.0 months) and patients without cholangitis (3.2 months). The investigators also found that patients with cholangitis before percutaneous transhepatic biliary drainage had a higher hazard ratio for 1-year mortality compared with patients with cholangitis after the procedure.

After successful percutaneous transhepatic biliary drainage, 54 of 291 patients received chemotherapy. The investigators found that the patients with cholangitis before the procedure had a shorter median survival (5.2 months) compared with patients with cholangitis after the procedure (9.4 months) and patients without cholangitis (15.3 months). The investigators’ findings suggest that consultation with an oncologist is necessary for assessing the possibility of chemotherapy for patients successfully treated with percutaneous transhepatic biliary drainage because of the notable survival benefit.

Disclosure: The study authors reported no conflicts of interest.

BMC Gastroenterology

---