Unresectable XXXX : percutaneous versus operative palliation.

@entity1 @entity5 @entity9727 @entity1578 @entity1346 @entity201 @entity255
BACKGROUND: Several nonoperative and operative options are available for palliation of @entity1 with unresectable @entity201 . This retrospective analysis compares the results of nonoperative percutaneous stenting and operative palliation in 65 @entity1 . METHODS: Twenty-one @entity1 were managed with percutaneous biliary stents (group A), and 44 @entity1 underwent laparotomy (group B) with placement of large-bore @entity1346 rubber transhepatic stents in 33. The two groups were similar with respect to age, gender, mean laboratory data, and @entity5 . RESULTS: Group A and group B @entity1 were comparable in hospital morbidity (67% vs 61%), hospital mortality (14% vs 7%), and mean initial hospital stay (27 vs 31 days). Survival was greater in group B laparotomy @entity1 at 1, 3, and 6 months (p < 0.01), and median survival was 5 months for group A compared with 8 months for group B @entity1 (p = 0.06). Group A @entity1 who were managed with percutaneous stents required more stent changes per month of survival (0.5 vs 0.3, p = 0.06). However, group B @entity1 who underwent operative palliation were more likely to undergo a second operation (0% vs 21%, p = 0.05), most often for @entity9727 . CONCLUSIONS: Operative placement of large-bore transhepatic stents may reduce @entity255 , @entity1578 , and prolong survival. We conclude that @entity1 with unresectable @entity201 who are fit for surgery may benefit from operative palliation.
