Biliary-pancreatic double stents for pancreatic cancer with obstructive jaundice / 中华消化内镜杂志

ABSTRACT

Objective To analysis the clinical effects of biliary-pancreatic double stents in pancreatic cancer patients with obstructive jaundice.Methods From July 2008 to October 2011,a total of 60 patients with advanced pancreatic cancer were randomly divided into two groups to receive biliary-pancreatic double stents (n =28) or biliary stent only (n =32) according to the odd and even numbers of their admission date.Changes in liver function,abdominal pain,quality of life scores (QOL) were compared between two groups.Results The stents were placed successfully in 54 patients (90.0％),in which symptoms were relieved or gradually disappeared in all patients after the procedure.One week after stents placement,the serum total bilirubin decreased significantly from 164.32 ±45.16 μmol/L before ERCP to 63.25 ±27.06 μmol/L (P ＜ 0.05),other parameters including ALT,AST,AKP and r-GT were also decreased significantly compared with those of pre-ERCP (P ＜ 0.01),but there was no significant difference between the two groups (P ＞ 0.05).25 cases in double-stents group and 29 cases in single-stent group had varying degrees of pain relief at 7d after ERCP,but the overall pain relief rate and complete pain relief rate in double-stent group were significantly higher than those in single-stent group (92.0％ vs.55.2％; 64.0％ vs.34.5％,P＜0.05).At 7d and 14d after ERCP,Karnofsky QOL score were improved significantly in double-stent group (P ＜ 0.05).It was significantly better than single-stent group at 14d after ERCP (P ＜0.05).No death or other severe ERCP-related complications were observed.Conclusion Biliary-pancreatic stent placement for pancreatic cancer could significantly improve liver function and relieve obstructive pain.In the ways of alleviating pain and improving quality of life scores,it was better than ERCP biliary stent placement,especially for patients with pancreatic cancer combined obstructive pain.It indicated that biliary-pancreatic stent placement was better than simple biliary stent placement for advanced pancreatic head cancer patients with obstructive pain.