Quality of Life Assessment after Percutaneous Transhepatic Biliary Drainage in Patients with Advanced Gall Bladder Carcinoma: A Prospective Interventional Study

Introduction: Gall Bladder Cancer (GBC) is associated with poor prognosis, particularly when presenting with jaundice. In these cases, jaundice often indicates advanced disease and precludes curative surgical options. Palliative management with biliary drainage may be the only available option to address symptom relief, restore liver function, and improve Quality Of Life (QOL). The impact of Percutaneous Transhepatic Biliary Drainage (PTBD) on QOL in such patients remains underexplored. Aim: To evaluate the effectiveness of PTBD in improving QOL in patients with advanced GBC and obstructive jaundice, using two validated QOL indices. Materials and Methods: A prospective interventional study in patients with unresectable GBC and jaundice undergoing PTBD was conducted on 70 patients at a tertiary care centre in northern India between 2019 and 2024. Just before and after PTBD, QOL was assessed using FACT-Hep and EORTC QLQ-BIL21/QLQ-C30 at three time points: preprocedure, one month postprocedure, and three months postprocedure. Data were analysed using descriptive statistics and repeated measures ANOVA. Results: Significant improvements were observed in overall QOL and key domains-physical, social, emotional, and functional well-being- between baseline and follow-ups (p<0.05). Jaundice-related symptoms, eating ability, and fatigue showed marked improvement, though pain and anxiety scores remained unchanged. Complications included periprocedural leaks in 22 patients (31.4%), catheter blockage or pull-out in 16 (22.9%), and cholangitis in 8 (11.4%). Conclusion: PTBD effectively improves QOL in patients with advanced GBC by alleviating jaundice-related symptoms and enhancing functional domains, despite procedural complications. Optimising post-procedural care and addressing complications are crucial for maximising palliative benefits in this patient population.