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Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma

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Title: Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma
Authors: Kawakami, Hiroshi Browse this author
Kuwatani, Masaki Browse this author
Onodera, Manabu Browse this author
Haba, Shin Browse this author
Eto, Kazunori Browse this author
Ehira, Nobuyuki Browse this author
Yamato, Hiroaki Browse this author
Kudo, Taiki Browse this author
Tanaka, Eiichi Browse this author
Hirano, Satoshi Browse this author
Kondo, Satoshi Browse this author
Asaka, Masahiro Browse this author
Keywords: Hilar cholangiocarcinoma
Preoperative biliary drainage
Endoscopic biliary drainage
Endoscopic nasobiliary drainage
Percutaneous transhepatic biliary drainage
Issue Date: Feb-2011
Publisher: SPRINGER TOKYO
Journal Title: JOURNAL OF GASTROENTEROLOGY
Volume: 46
Issue: 2
Start Page: 242
End Page: 248
Publisher DOI: 10.1007/s00535-010-0298-1
PMID: 20700608
Abstract: Controversy exists over the preferred technique of preoperative biliary drainage (PBD) in patients with hilar cholangiocarcinoma (HCA). The goal of this retrospective study was to identify the preferred technique of PBD for HCA. A total of 128 consecutive patients with HCA diagnosed between September 1999 and December 2009 who underwent PBD were included in this study. The study compared outcomes of endoscopic nasobiliary drainage (ENBD), endoscopic biliary stenting (EBS), and percutaneous transhepatic biliary drainage (PTBD) in patients with HCA. There were no significant differences in preoperative laboratory data, rates of major hepatectomy, or decompression periods among the 3 groups. Complications were significantly more frequent in the EBS group compared with either the ENBD or PTBD group (p < 0.05). Drainage tube occlusion with cholangitis was significantly more common in the EBS group compared with either the ENBD or PTBD group (p < 0.0001). Patients in the PTBD group experienced serious complications including vascular injury (8%) and cancer dissemination (4%). Patients in the ENBD and EBS groups had mild post-endoscopic retrograde cholangiopancreatography pancreatitis (5%). Conversion procedures were significantly more common in the EBS group compared with the ENBD and PTBD groups (p < 0.05). There was no significant difference in postsurgical morbidity or mortality among the 3 groups. Drainage tube occlusion with cholangitis was a frequent complication associated with EBS. PTBD was associated with serious complications such as vascular injury and cancer dissemination. ENBD was found to be the most suitable method for initial PBD management in patients with HCA.
Rights: The original publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/44960
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 河上 洋

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