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White bile in patients with malignant biliary obstruction is an independent factor of poor survival

Background and study aims  White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obst...

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Autores principales: Dʼalmeida, Rosario, Barbe, Coralie, Untereiner, Valérie, Ramaholimihaso, Fidy, Renard, Pascal, Sockalingum, Ganesh D., Garnotel, Roselyne, Thiefin, Gérard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857955/
https://www.ncbi.nlm.nih.gov/pubmed/33553582
http://dx.doi.org/10.1055/a-1324-2721
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author Dʼalmeida, Rosario
Barbe, Coralie
Untereiner, Valérie
Ramaholimihaso, Fidy
Renard, Pascal
Sockalingum, Ganesh D.
Garnotel, Roselyne
Thiefin, Gérard
author_facet Dʼalmeida, Rosario
Barbe, Coralie
Untereiner, Valérie
Ramaholimihaso, Fidy
Renard, Pascal
Sockalingum, Ganesh D.
Garnotel, Roselyne
Thiefin, Gérard
author_sort Dʼalmeida, Rosario
collection PubMed
description Background and study aims  White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obstruction due to biliary or pancreatic cancer. Patients and methods  The study was conducted on a series of consecutive patients with malignant obstructive jaundice. They all underwent endoscopic retrograde cholangiopancreatography with collection of bile and biliary stent insertion. White bile was defined as bile duct fluid with bilirubin level < 20 µmol/L. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS). Results  Seventy-three patients were included (32 pancreatic cancers, 41 bile duct cancers). Thirty-nine (53.4 %) had white bile. The mean bile duct bilirubin level in this group was 4.2 ± 5.9 µmol/L vs 991 ± 1039 µmol/L in patients with colored bile (P < 0.0001). In the group of 54 patients not eligible for surgery, the multivariate analysis demonstrated an association between the presence of white bile and reduced OS (HR 2.3, 95 %CI 1.1–4.7; P = 0.02). Other factors independently associated with OS were metastatic extension (HR 2.8, 95 %CI 1.4–5.7) and serum total bilirubin (HR 1.003, 95 %CI 1.001–1.006). There was a significant inverse correlation between serum and bile duct bilirubin levels (r = –0.43, P = 0.0001). Conclusion  White bile in patients with inoperable malignant biliary obstruction is an independent factor of poor survival.
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spelling pubmed-78579552021-02-05 White bile in patients with malignant biliary obstruction is an independent factor of poor survival Dʼalmeida, Rosario Barbe, Coralie Untereiner, Valérie Ramaholimihaso, Fidy Renard, Pascal Sockalingum, Ganesh D. Garnotel, Roselyne Thiefin, Gérard Endosc Int Open Background and study aims  White bile is defined as a colorless fluid occasionally found in the biliary tract of patients with bile duct obstruction. Its significance is not clearly established. Our objective was to analyze the prognostic value of white bile in a series of patients with biliary obstruction due to biliary or pancreatic cancer. Patients and methods  The study was conducted on a series of consecutive patients with malignant obstructive jaundice. They all underwent endoscopic retrograde cholangiopancreatography with collection of bile and biliary stent insertion. White bile was defined as bile duct fluid with bilirubin level < 20 µmol/L. Univariate and multivariate analyses were performed to identify variables associated with overall survival (OS). Results  Seventy-three patients were included (32 pancreatic cancers, 41 bile duct cancers). Thirty-nine (53.4 %) had white bile. The mean bile duct bilirubin level in this group was 4.2 ± 5.9 µmol/L vs 991 ± 1039 µmol/L in patients with colored bile (P < 0.0001). In the group of 54 patients not eligible for surgery, the multivariate analysis demonstrated an association between the presence of white bile and reduced OS (HR 2.3, 95 %CI 1.1–4.7; P = 0.02). Other factors independently associated with OS were metastatic extension (HR 2.8, 95 %CI 1.4–5.7) and serum total bilirubin (HR 1.003, 95 %CI 1.001–1.006). There was a significant inverse correlation between serum and bile duct bilirubin levels (r = –0.43, P = 0.0001). Conclusion  White bile in patients with inoperable malignant biliary obstruction is an independent factor of poor survival. Georg Thieme Verlag KG 2021-02 2021-02-03 /pmc/articles/PMC7857955/ /pubmed/33553582 http://dx.doi.org/10.1055/a-1324-2721 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Dʼalmeida, Rosario
Barbe, Coralie
Untereiner, Valérie
Ramaholimihaso, Fidy
Renard, Pascal
Sockalingum, Ganesh D.
Garnotel, Roselyne
Thiefin, Gérard
White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title_full White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title_fullStr White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title_full_unstemmed White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title_short White bile in patients with malignant biliary obstruction is an independent factor of poor survival
title_sort white bile in patients with malignant biliary obstruction is an independent factor of poor survival
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857955/
https://www.ncbi.nlm.nih.gov/pubmed/33553582
http://dx.doi.org/10.1055/a-1324-2721
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