title: Outcomes and risk factors for cancer patients undergoing endoscopic intervention of malignant biliary obstruction
creator: Haag, Georg-Martin
creator: Herrmann, Thomas
creator: Jäger, Dirk
creator: Stremmel, Wolfgang
creator: Schemmer, Peter
creator: Sauer, Peter
creator: Gotthardt, Daniel Nils
subject: ddc-610
subject: 610 Medical sciences Medicine
description: Background: Malignant bile duct obstruction is a common problem among cancer patients with hepatic or lymphatic metastases. Endoscopic retrograde cholangiography (ERC) with the placement of a stent is the method of choice to improve biliary flow. Only little data exist concerning the outcome of patients with malignant biliary obstruction in relationship to microbial isolates from bile.   Methods: Bile samples were taken during the ERC procedure in tumor patients with biliary obstruction. Clinical data including laboratory values, tumor-specific treatment and outcome data were prospectively collected.   Results: 206 ERC interventions in 163 patients were recorded. In 43 % of the patients, systemic treatment was (re-) initiated after successful biliary drainage. A variety of bacteria and fungi was detected in the bile samples. One-year survival was significantly worse in patients from whom multiresistant pathogens were isolated than in patients, in whom other species were detected. Increased levels of inflammatory markers were associated with a poor one-year survival. The negative impact of these two factors was confirmed in multivariate analysis. In patients with pancreatic cancer, univariate analysis showed a negative impact on one-year survival in case of detection of Candida species in the bile. Multivariate analysis confirmed the negative prognostic impact of Candida in the bile in pancreatic cancer patients.   Conclusion: Outcome in tumor patients with malignant bile obstruction is associated with the type of microbial biliary colonization. The proof of multiresistant pathogens or Candida, as well as the level of inflammation markers, have an impact on the prognosis of the underlying tumor disease.
publisher: BioMed Central
date: 2015
type: Article
type: info:eu-repo/semantics/article
type: NonPeerReviewed
format: application/pdf
identifier: https://archiv.ub.uni-heidelberg.de/volltextserverhttps://archiv.ub.uni-heidelberg.de/volltextserver/19914/1/12876_2015_Article_399.pdf
identifier: DOI:
identifier: urn:nbn:de:bsz:16-heidok-199148
identifier:   Haag, Georg-Martin ; Herrmann, Thomas ; Jäger, Dirk ; Stremmel, Wolfgang ; Schemmer, Peter ; Sauer, Peter ; Gotthardt, Daniel Nils  (2015) Outcomes and risk factors for cancer patients undergoing endoscopic intervention of malignant biliary obstruction.  BMC Gastroenterology, 15 (171).  pp. 1-7.  ISSN 1471-230X     
relation: https://archiv.ub.uni-heidelberg.de/volltextserver/19914/
rights: info:eu-repo/semantics/openAccess
rights: Please see front page of the work (Sorry, Dublin Core plugin does not recognise license id)
language: eng