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THE IMPACT OF ENDOSCOPIC BILIARY DRAINAGE ON THE NUTRITIONAL STATUS OF PATIENTS WITH MALIGNANT PERIHILAR OR PERIAMPULLARY BILIARY STRICTURES

Mohamed Acharki 1,2, Yasmine Essadni 1, Imane Boussena 2, Nawal Kabbaj 1, Abdellatif Bour 2

Affiliations

1 EFD-HGE Unit, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco

2 Department of biology, Laboratory of biology and health, Team of nutrition, food and health science, Faculty of science, Ibn Tofail University, Kénitra, Morocco

Summary

AI Generated

Retrospective study of 200 patients with malignant biliary stenosis shows endoscopic biliary drainage significantly improved nutritional and clinical parameters at 1 and 3 months post-procedure, regardless of obstruction location.

Mean weight increased from 56.95 kg to 59.27 kg and BMI from 19.63 to 20.39 kg/m² at 3 months (p<0.05), though 35.17% still had severe undernutrition by Nutritional Risk Index.
Mean albumin rose from 29 g/l to 34.52 g/l and total bilirubin decreased from 200.72 mg/l to 15.03 mg/l at 3 months (both p<0.05), while C-reactive protein change was not statistically significant.
WHO performance status improved significantly with 25% reaching Stage 0 at 3 months; pruritus and jaundice resolved in 100% and vomiting in 90% of patients.
No significant differences were observed between perihilar and periampullary stenosis groups for any parameter studied.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Malignant biliary obstruction is the cause of numerous complications affecting nutritional status. Biliary drainage with stenting is the recommended palliative treatment for these patients. This study assesses the impact of biliary drainage on nutritional status by comparing patients before and after the procedure.

Aims & Methods

The aim of this study was to evaluate, through a retrospective analysis, the variation in patients nutritional status before and after biliary drainage wether in perihilar or periampullary strictures.
We studied 200 patients with malignant biliary stenosis who underwent endoscopic biliary drainage. Demographic, anthropometric and clinical data were collected before and after drainage in two stages (1 month and 3 months). Statistical analysis was performed using SPSS26 software.

Results

The results showed a significant increase in mean weight, reaching 59.27kg after 3 months (p<0.05). Mean BMI also increased significantly, (20.39kg/m² after 3 months (p<0.05)). NRI (Nutritional risk index) decreased significantly after drainage. 35.17% still had severe undernutrition after 3 months (p<0.05). Mean ALB (Albumin) increased significantly, (34.52g/l after 3 months (p<0.05)). Mean TB (Total Bilirubin) also decreased significantly, (15.03mg/l after 3 months (p<0.05)). However, the decrease in CRP was not statistically significant. The WHO performance score showed significant improvement, with 25% of patients presenting with Stage 0 after 3 months. Pruritus and jaundice were absent in 100% of patients after 3 months, and vomiting absent in 90% of patients after 3 months (p<0.05). When comparing the perihilar and periampullary stenosis groups, no significant differences were observed for any of the parameters studied.

	BEFORE DRAINAGE	1 MONTH AFTER DRAINAGE		3 MONTHS AFTER DRAINAGE
	Mean (SD) or %	Mean (SD) or %	*P value*	Mean (SD) or %	*P value*
WHO score -STAGE 0 - STAGE 1 - STAGE 2 - STAGE 3	4.1% 43.2% 52.1% 0.6%	14.4% 53.2% 24.3% 3.6%	*0.000*	25% 53.6% 17.9% 8.1%	*0.000*
WEIGHT (Kg)	56.95 kg (±9.83)	57 kg (±10.11)	*0.000*	59.27 kg (±10.14)	*0.000*
BMI Kg/m²	19.63 kg/ m² (±3.42)	19.66kg/m² (±3.40)	*0.000*	20.39 kg/m² (±3.46)	*0.000*
NRI Normal nutrition Moderate undernutrition Severe undernutrition	0 (0%) 70 (35%) 130 (65%)	12 (6.84%) 86 (48.86%) 78 (44.31%)	*0.000*	25 (17.24%) 79 (54.48%) 41 (35.17%)	*0.000*
ALBUMIN (ALB)	29 g/l (±4.31)	32 g/l (±5.48)	0.000	34.52 g/l (±4.5)	*0.000*
TOTAL BILIRUBIN (TB)	200.72mg/l (±105.94)	32.82mg/l (±34.3)	*0.000*	15.03mg/l (±23.96)	*0.000*
C-REACTIVE PROTEIN (CRP)	61.73 mg/l	57.1mg/l	*0.89*	56mg/l	*0.80*

Conclusion

The study suggest that endoscopic biliary drainage significantly improves the nutritional and clinical status of patients with malignant biliary strictures, independently of the location of the obstruction.

Disclosure

No conflict of interest.

Conference

UEG Week Vienna 2024

Topics

Hepatobiliary

Submission format

Abstract

Session

BILIARY (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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