ABSTRACT
Background: Cholangiocarcinoma and other malignant biliary tract diseases are common causes of obstructive jaundice in elderly patients. Despite advances in imaging these tumors are usually detected at a stage when the resection is no longer possible. In all such cases palliative Interventional Radiology Management with S.E.M.S (Self Expanding Metallic Stents) is one of the best possible palliative treatment options. Utility of pro-inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as prognostic markers for predicting various complications in these patients have been studied by very few researchers. We have conducted this study to find out whether raised NLR and PLR values can be used as prognostic factors in patients undergoing SEMS.Methods: This was a prospective study conducted in the department of interventional radiology of a medical college situated in a rural area. Patients who have undergone SEMS for palliative management of biliary tract cancers were included in this study on the basis of predefined inclusion and exclusion criteria. NLR and PLR were calculated from complete blood count. The analysis of complication rates (cholangitis, cholecystitis, pancreatitis or any other complication) and sepsis was done in relation to NLR and PLR ratio. Statistical analysis was done with Minitab version 17.Results: Out of 76 patients included in this study there were 50 males and 26 females with a M: F ratio of 1:0.52. The most common affected age group was found to be between 41-50 years (26.31%). The most common malignancy encountered was found to be Perihilar cholangiocarcinoma (including its subtypes) (34.21%) followed by distal cholangiocarcinoma (28.94%), intrahepatic cholangiocarcinoma (18.42%), Gall Bladder Carcinoma (13.15%) and Periampullary carcinoma (5.26%). NLR values of more than 3 and PLR values of more than 150 were associated with increased chances of complications and sepsis. Conclusions: Raised values of Neutrophil to Lymphocyte ratio (NLR) and Platelet to lymphocyte ratio (PLR) were found to be associated with increased chances of sepsis and other complications. However further randomized controlled trials are needed to validate prognostic ability of these ratios.