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Preoperative biliary drainage for hilar cholangiocarcinoma : which stent should be selected?

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Title: Preoperative biliary drainage for hilar cholangiocarcinoma : which stent should be selected?
Authors: Kawakami, Hiroshi Browse this author →KAKEN DB
Kondo, Satoshi Browse this author
Kuwatani, Masaki Browse this author
Yamato, Hiroaki Browse this author
Ehira, Nobuyuki Browse this author
Kudo, Taiki Browse this author
Eto, Kazunori Browse this author
Haba, Shin Browse this author
Matsumoto, Joe Browse this author
Kato, Kentaro Browse this author
Tsuchikawa, Takahiro Browse this author
Tanaka, Eiichi Browse this author
Hirano, Satoshi Browse this author
Asaka, Masahiro Browse this author
Keywords: Hilar cholangiocarcinoma
Preoperative biliary drainage
Endoscopic biliary drainage
Endoscopic nasobiliary drainage
Bilateral biliary drainage
Issue Date: Sep-2011
Publisher: Springer Japan
Journal Title: Journal of Hepato-Biliary-Pancreatic Sciences
Volume: 18
Issue: 5
Start Page: 630
End Page: 635
Publisher DOI: 10.1007/s00534-011-0404-7
PMID: 21655974
Abstract: The controversy over whether and how to perform preoperative biliary drainage (PBD) in patients with hilar cholangiocarcinoma (HCA) remains unsettled. Arguments against PBD before pancreatoduodenectomy have recently been gaining momentum. However, the complication-related mortality rate is as high as 10% for patients with HCA who have undergone major liver resection, and liver failure is a major cause of postoperative death. This suggest the need for PBD to treat jaundice in HCA patients scheduled for major surgical resection of the liver and to perform major surgery only after recovery of hepatic function. No definite criteria or guidelines outlining indications for PBD are currently available. In patients with HCA, PBD may be performed by either percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary drainage (EBD). No consensus, however, has been reached regarding which drainage method is more appropriate. No reported study has compared the effectiveness of PTBD, endoscopic biliary stenting (EBS), and endoscopic nasobiliary drainage (ENBD) in patients with HCA. This review summarizes the results of our study comparing the three methods and outlines the preoperative endoscopic management of segmental cholangitis (SC) in HCA patients undergoing PBD.
Rights: The original publication is available at
Type: article (author version)
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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