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Malignant biliary obstruction and percutaneous drainage: MELD score and survival prediction
  1. Alia Alawneh1,
  2. Fadi Abu Farsakh2,
  3. Ayoub Innabi3 and
  4. Wael Tuqan4
  1. 1 Internal medicine, Jordan University of Science and Technology, Irbid, Jordan
  2. 2 Palliative medicine department, King Hussein Cancer Center, Amman, Jordan
  3. 3 Palliative medicine department, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  4. 4 Gastroenterology, Ochsner Medical Center - New Orleans, Jefferson, Louisiana, USA
  1. Correspondence to Dr Alia Alawneh; aaalawneh8{at}just.edu.jo

https://doi.org/10.1136/spcare-2022-003826

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    Malignant biliary obstruction (MBO) is a debilitating condition that affects significantly the quality of life by causing anorexia, fatigue and pruritus, it can also interfere with the administration of palliative chemotherapy. Unfortunately, patients with MBO often present at a late stage of their illness and treatment usually focuses on reliving the symptoms. The optimal intervention for MBO is internal drainage by placement of metallic stent. For patients in whom endoscopic intervention is not feasible, a percutaneous transhepatic biliary dilatation (PTBD) by interventional radiologist is preferred. PTBD was found to improve pruritus and often reduces hyperbilirubinaemia to a level that does not contraindicate the administration of chemotherapy; however, PTBD is associated with a significant rate of complications, which may impair patients’ quality of life. In addition, patients often have poor prognosis which may not allow them to benefit from the intervention. Therefore, a prognostic model of survival is needed for this subgroup of patients to help healthcare providers and patients make an informed decision regarding this procedure. In a previous study,1 we aimed to identify the predictive factors of survival in MBO post PTBD, presence of ascites was a significant prognostic …

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    Footnotes

    • Contributors AA contributed to study design, data analysis and manuscript writing. FAF contributed to study design, data collection and analysis. AI contributed to study design, data collection and analysis. WT contributed to study design, data collection and analysis.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.