TY - JOUR
T1 - Biliary stenting in patients with pancreatic cancer : results from a population-based cohort study
AU - Payne, Madeleine
AU - Burmeister, Elizabeth A.
AU - Waterhouse, Mary
AU - Jordan, Susan J.
AU - O'Connell, Dianne L.
AU - Merrett, Neil D.
AU - Goldstein, David
AU - Wyld, David
AU - Beesley, Vanessa L.
AU - Gooden, Helen
AU - Janda, Monika
AU - Neale Rachel E., Rachel E.
PY - 2018
Y1 - 2018
N2 - Objective We aimed to describe management of biliary obstruction (BO) in the context of pancreatic cancer within a population-based cohort. Methods We examined management of BO in 1863 patients diagnosed as having pancreatic cancer in 2010/2011. We used descriptive statistics and logistic regression to describe patterns of biliary stent usage, complications and duration of patency, associations between preoperative stenting and surgical outcomes, and between patient factors and management of jaundice. Results Almost half of the people in the cohort (n = 909) were jaundiced within 12 months of diagnosis. Two-thirds of these had at least 1 stent inserted. Preoperative stenting, mostly with plastic stents, occurred for 72% of patients who experienced jaundice prior to an attempted resection but was not associated with surgical outcomes. Seventy percent of the jaundiced patients who did not have an attempted resection were stented. Metal stents were less frequently replaced within 30 days than plastic (9% vs 42%). Living in a rural area was associated with reduced likelihood of having jaundice managed. Conclusions Plastic stents were still used frequently, despite guidelines recommending metal in most contexts. Patients living in rural areas were less likely to have BO managed. This work highlights the need to monitor current practice.
AB - Objective We aimed to describe management of biliary obstruction (BO) in the context of pancreatic cancer within a population-based cohort. Methods We examined management of BO in 1863 patients diagnosed as having pancreatic cancer in 2010/2011. We used descriptive statistics and logistic regression to describe patterns of biliary stent usage, complications and duration of patency, associations between preoperative stenting and surgical outcomes, and between patient factors and management of jaundice. Results Almost half of the people in the cohort (n = 909) were jaundiced within 12 months of diagnosis. Two-thirds of these had at least 1 stent inserted. Preoperative stenting, mostly with plastic stents, occurred for 72% of patients who experienced jaundice prior to an attempted resection but was not associated with surgical outcomes. Seventy percent of the jaundiced patients who did not have an attempted resection were stented. Metal stents were less frequently replaced within 30 days than plastic (9% vs 42%). Living in a rural area was associated with reduced likelihood of having jaundice managed. Conclusions Plastic stents were still used frequently, despite guidelines recommending metal in most contexts. Patients living in rural areas were less likely to have BO managed. This work highlights the need to monitor current practice.
KW - bile
KW - cancer
KW - pancreas
KW - stents (surgery)
UR - http://handle.westernsydney.edu.au:8081/1959.7/uws:45400
UR - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006676-201801000-00012&LSLINK=80&D=ovft
U2 - 10.1097/MPA.0000000000000960
DO - 10.1097/MPA.0000000000000960
M3 - Article
SN - 0885-3177
VL - 47
SP - 80
EP - 86
JO - Pancreas
JF - Pancreas
IS - 1
ER -