Wang W, Zhang C, Li B, Yuan GYL, Zeng ZW. Clinical evaluation of endoscopic biliary stenting in treatment of malignant obstructive jaundice. World J Gastrointest Surg 2025; 17(1): 97596 [DOI: 10.4240/wjgs.v17.i1.97596]
Corresponding Author of This Article
Zhi-Wu Zeng, Department of General Surgery, Shenzhen University General Hospital, No. 1098 Xueyuan Avenue, Nanshan District, Shenzhen 518000, Guangdong Province, China. zzw0755@163.com
Research Domain of This Article
Gerontology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wei Wang, Chao Zhang, Bing Li, Ge-Yi-Lang Yuan, Department of Hepatobiliary Surgery, Wuhan No. 1 Hospital, Wuhan 430000, Hubei Province, China
Zhi-Wu Zeng, Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518000, Guangdong Province, China
Co-first authors: Wei Wang and Chao Zhang.
Author contributions: Wang W wrote the main manuscript; Wang W and Zhang C contributed equally to this article as co-first authors; Zhang C and Li B prepared the data collection; Zhang C and Yuan GYL prepared the tables; Wang W and Zeng ZW analyzed and interpreted the results; all authors reviewed the results and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the Wuhan No. 1 Hospital, No. [2022]55.
Informed consent statement: All methods were carried out in accordance with Declaration of Helsinki. All the authors confirming that written informed consent was obtained from all subjects and/or their legal guardian(s).
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The experimental data used to support the findings of this study are available from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Wu Zeng, Department of General Surgery, Shenzhen University General Hospital, No. 1098 Xueyuan Avenue, Nanshan District, Shenzhen 518000, Guangdong Province, China. zzw0755@163.com
Received: June 3, 2024 Revised: October 23, 2024 Accepted: November 12, 2024 Published online: January 27, 2025 Processing time: 207 Days and 4.4 Hours
Abstract
BACKGROUND
Malignant obstructive jaundice (MOJ) is characterized by the presence of malignant tumors infiltrating or compressing the bile duct, causing poor bile drainage, generalized yellowing, pain, itching, and malaise. MOJ is burdensome for both the society and the families of affected patients and should be taken seriously.
AIM
To evaluate the clinical effect of stent placement during endoscopic retrograde cholangiopancreatography for relieving MOJ and the efficacy of percutaneous transhepatic biliary drainage in terms of liver function improvement, complication rates, and long-term patient outcomes.
METHODS
The clinical data of 59 patients with MOJ who were admitted to our hospital between March 2018 and August 2019 were retrospectively analyzed. According to the treatment method, the patients were divided into an observation group (29 patients) and a control group (30 patients). General data, liver function indices, complications, adverse effects, and 3-year survival rates after different surgical treatments were recorded for the two groups.
RESULTS
There were no significant differences in baseline information (sex, age, tumor type, or tumor diameter) between the two groups (P > 0.05). Alanine aminotransferase, aspartate aminotransferase, and total bilirubin levels were significantly better in both groups after surgery than before surgery (P < 0.05). The overall incidence of biliary bleeding, gastrointestinal bleeding, pancreatitis, and cholangitis was 6.9% in the observation group and 30% in the control group (P < 0.05). No significant differences in the rates of blood transfusion, intensive care unit admission, or death within 3 years were observed between the two groups at the 1-month follow-up (P > 0.05). The 3-year survival rates were 46.06% and 39.71% in the observation and control groups, respectively.
CONCLUSION
Endoscopic biliary stenting effectively relieves MOJ and significantly improves liver function, with minimal complications. This technique is a promising palliative approach for patients ineligible for radical surgery. However, further research is needed to optimize current treatment strategies and to explore their potential in treating nonmalignant cases of obstructive jaundice.
Core Tip: This study evaluated the clinical efficacy of endoscopic biliary stenting in the treatment of malignant obstructive jaundice. The findings demonstrate that endoscopic treatment significantly improves liver function and is associated with fewer complications than percutaneous biliary drainage. Although the survival rates between the two groups were not markedly different, the observation group presented better short-term clinical outcomes. These findings suggest that endoscopic biliary stenting is a valuable treatment option for patients with malignant obstructive jaundice, especially those ineligible for radical surgery.
