ENDOSCOPIC BILIARY DRAINAGE IN THE PALLIATIVE TREATMENT OF KLATSKIN TUMOURS: OUTCOMES AND FACTORS ASSOCIATED WITH SUCCESS OR FAILURE

Aims The aim is to report the results of endoscopic biliary drainage as well as the factors associated with its success or failure.

Methods This is a retrospective and analytical study of 75 patients, conducted between July 2009 and August 2021, including all patients admitted with a Klatskin's tumour and for whom endoscopic drainage was indicated.

Factors associated with the success or failure of endoscopic treatment were studied by logistic regression analysis.

Statistical analysis was performed using SPSS version 22.0 software.

Results The average age was 62.67+/-12 years. Our series was characterised by a male predominance of 68%.

Endoscopic drainage was successfully performed in 81.3% of patients.

Dilation was performed in 47% of cases.

In multivariate analysis and adjusting for age, gender, Bismuth tumour type, presence of metastases and endoscopic dilatation of the stenosis, only the presence of metastases, endoscopic dilation and Bismuth tumour type modified the success rate.

Indeed, endoscopic dilatation prior to stenting increases the success rate by a factor of 4 [OR=4; p=0.01], whereas the presence of metastases decreases this rate by 65% [OR=0.35; p<0.001]. However, tumours classified as Bismuth IV [OR=8; p<0.001] or Bismuth IIIa [OR=5; p=0.004] were associated with a risk of endoscopic treatment failure.

Conclusions Our study suggests that the presence of metastatic hilar cholangiocarcinoma classified as Bismuth IV or Bismuth IIIa appear to be associated with failure of endoscopic biliary drainage, whereas endoscopic dilatation prior to prosthesis placement appears to be associated with success.

Publication History

Article published online:
14 April 2022