Comparative analysis of biliodigestive anastomosis and retrograde stenting with metal stent in malignant distal biliary obstruction

Abstract

Introduction. Purpose of the study. To conduct a comparative analysis of the formation of biliodigestive anastomosis (BDA) and retrograde stenting with a metal stent (SMS) for malignant distal biliary obstruction (MDBO). Research methods. At the Botkin Hospital (Moscow) from 2015 to 2019. We conducted a retrospective analysis of the treatment of ADHD. The patients were divided into two groups: G1 – BDA formation was performed (n=34), G2 – retrograde stenting of the VMS (n=45). Characteristics of the groups: age G1 64,1±12,2, G2 68,4±9,9 (p=0,088); gender (m/f) G1 11/23, G2 14/31 (p=0,906); ECOG G1 2,1±0,4, G2 1,9±0,5 (p=0,052); Cancer (pancreas/choledochus): G1 25/9, G2 34/11 (p=0,838). Results. Patients G1 had a longer length of hospital stay of more than 10 days (61,3 % vs. 21,5 %, p < 0,05). The average duration of inpatient treatment in Group 1 was 18,1±3,8 days, in group 2 10,5±2,9 days (p=0,001). In G1, 41,2 % of hospital complications were detected, versus 17,8 % in G2 (p=0,026). In G1, hospital mortality was 2,9 %, versus 0 % in G2 (p=0,43). Readmission 59,4 % in G1, 42,1 % in G2 (p=0,115), start of the first chemotherapy procedure in G1 34,5±5,8 days, in G2 21,3±4,2 days, (p= 0,001). The likelihood of recurrent biliary obstruction was significantly lower in G2 (16,4 % vs. 73,1 % (p=0,001). Conclusion. Retrograde implantation of SMS is the preferred procedure for PVD. The formation of BDA should be carried out according to individual indications.