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News

Biliary and duodenal stents effective in pancreatic cancer care

Endoscopic palliative treatment of both biliary and duodenal stenoses is safe and effective in the long term in patients with unresectable adenocarcinoma of the head of pancreas, reports April's American Journal of Gastroenterology.

News image

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Life expectancy in patients with unresectable pancreatic cancer has improved by using new chemotherapeutic regimens.

Biliary and digestive stenoses can be endoscopically treated in most cases.

However, long-term efficacy of these stenting procedures remains unknown.

Dr Frédérique Maire and colleagues evaluated the incidence of biliary and duodenal stenoses.

The research team also assessed the technical success and short- and long-term patency of endoscopically deployed stents in unresectable pancreatic cancer.

The team retrospectively studied 100 consecutive patients with unresectable cancer of the pancreas between 1999 and 2003 at their center.

Patients with biliary and/or duodenal stenoses underwent endoscopic stent insertion as first intention therapy.

The researchers' outcomes included technical and clinical success, stent patency, and survival.

Repeat procedures are rarely required, even in patients who have a long survival
American Journal of Gastronenterology

The patients' median age was 65 years, 62% had locally advanced, and 38% had metastatic pancreatic cancer.

The team reported that 83% received at least 1 line of chemotherapy.

The actuarial median survival was 11 months.

The research team noted that biliary and duodenal stenoses occurred in 81 and 25 patients, respectively.

A biliary stent was successfully placed in 91% of patients.

The team introduced a self-expandable metallic stent in 59 patients, and found that a single stent was sufficient in 41 patients.

Duodenal stenting was successful in 96% of patients, and 96% only required a single stent.

In the 23 patients who developed both biliary and duodenal stenoses, the researchers observed that combined stenting was successful in 91%.

No major complication or death occurred related to endoscopic treatment.

Dr Maire's team concluded, “Endoscopic palliative treatment of both biliary and duodenal stenoses is safe and effective in the long term, including in patients with combined obstructions.”

“Use of such palliative management is justified, as repeat procedures are rarely required, even in patients who have a long survival.”

Am J Gastroenterol 2006: 101(4): 735
18 April 2006

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