Endoscopic Biliary Drainage Best for Pancreatic Cancer

Procedure is cheaper and gives better quality of life than surgery

WEDNESDAY, Sept. 27 (HealthDay News) -- In patients with metastatic pancreatic cancer who require treatment of biliary obstruction, endoscopic biliary drainage is cheaper and also gives patients a better quality of life than surgery, according to a study published in the September issue of the American Journal of Gastroenterology.

Everson L.A. Artifon, M.D., Ph.D., of the University of Sao Paulo in Sao Paulo, Brazil, and colleagues conducted a randomized, controlled trial of 30 patients with pancreatic cancer who underwent either surgery (choledochojejunostomy or gastrojejunostomy) or endoscopic biliary drainage using a metal stent inserted into the bile duct.

Neither procedure resulted in any mortality within the first 30 days and complication rates, re-admissions for complications and duration of survival were the same in both groups. The total cost of care was lower in the endoscopy group than for the surgical group: an average $4,271 versus an average $8,321. Quality-of-life scores reported by patients at 30 and 60 days were higher in the endoscopy group.

"Endoscopic biliary drainage is cheaper than surgery with better quality of life in patients with biliary obstruction and metastatic pancreatic cancer," the authors conclude. "Further studies are needed to evaluate the effect of endoscopic therapy in patients who present with both biliary and gastroduodenal obstruction compared with surgery," they note.

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