Abstract

Background: Extrahepatic cholangiocarcinoma (eCCA) poses a significant clinical challenge, particularly in older individuals. This retrospective study,  conducted atMacKayMemorial Hospital, evaluates the clinical efficacy of biliary drainage in older patients with eCCA, focusing specifically on its impact on survival.

Methods: We retrospectively reviewed 36 older patients diagnosed with eCCA via pathology between 2015 and 2022. Biliary drainage was categorized as  either endoscopic retrograde biliary drainage (ERBD) or percutaneous transhepatic cholangial drainage (PTCD).We compared survival curves and basic characteristics between patients who received biliary drainage and those who did not, using the Kaplan-Meier method, t-tests, and Chi-square analysis.

Results: Of the 36 patients, 28 had received biliary drainage prior to any anti-cancer treatment. Of these 28 patients, 20 underwent ERBD, whereas the remaining eight received PTCD. The mean age of the eCCA cohort was 74.1 years. The mean and median survival times for the non-drainage group were 4.3
months and 4 months, respectively. In contrast, the mean and median survival times for patients who had received biliary drainage were 10.4 months and 12 months, respectively. The difference in mean survival was statistically significant (p = 0.024).

Conclusion: Biliary drainage may benefit older patients with eCCA. The extended survival observed in patients who underwent biliary drainage highlights the importance of this intervention in the context of a challenging malignancy.