Endoscopic Nasobiliary Drainage Comparable with Endoscopic Biliary Stenting as a Preoperative Drainage Method for Malignant Hilar Biliary Obstruction: A Multicenter Retrospective Study

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud Rent for 48h to view Buy Cloud Access for unlimited viewing via different devices Synchronizing in the ReadCube Cloud Printing and saving restrictions apply Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: August 03, 2021
Accepted: December 13, 2021
Published online: January 26, 2022

Number of Print Pages: 12
Number of Figures: 5
Number of Tables: 6

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

Abstract

Introduction: Preoperative endoscopic biliary drainage (PEBD) for malignant hilar biliary obstruction (MHBO) is widely accepted. Recent PEBD consists of endoscopic nasobiliary drainage (ENBD), conventional endoscopic biliary stenting (CEBS) with plastic stents across the papilla, and endoscopic biliary inside stenting (EBIS) with plastic stents above the papilla, while ENBD is the primary procedure in Asian countries. Thus, we aimed to compare the efficacy of ENBD with those of CEBS and EBIS as a means of PEBD for MHBO. Methods: We retrospectively identified patients with MHBO who underwent upfront surgery between January 2011 and December 2018 in a multicenter setting. The outcome measures were cumulative dysfunction of PEBD, risk factors for PEBD dysfunction, and adverse events. Results: We analyzed a total of 219 patients, comprising 163 males (74.4%); mean age, 69.7 (±7.6) years; Bismuth-Corlette (BC) classification I, II, IIIa, IIIb, and IV in 68, 49, 43, 30, and 29 patients, respectively; and diagnosis of hilar cholangiocarcinoma and gallbladder cancer in 188 and 31 patients, respectively. PEBD procedures were performed in 160 patients with ENBD, 31 patients with CEBS, and 28 patients with EBIS. PEBD dysfunction occurred in 58 patients (26.5%), and the cumulative dysfunction rates were not significantly different among PEBD methods (p = 0.60). Multivariate analysis showed that BC-IV was significantly associated with the occurrence of PEBD dysfunction (hazard ratio = 2.10, p = 0.02). The adverse event rates were not significantly different among PEBD groups (p = 0.70). Conclusion: ENBD as a means of PEBD for MHBO is comparable with CEBS and EBIS in rates of dysfunction and adverse events.

© 2022 S. Karger AG, Basel

References Hirano S, Kondo S, Tanaka E, Shichinohe T, Tsuchikawa T, Kato K, et al. Outcome of surgical treatment of hilar cholangiocarcinoma: a special reference to postoperative morbidity and mortality. J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):455–62. Nasu Y, Tanaka E, Hirano S, Tsuchikawa T, Kato K, Matsumoto J, et al. The prognosis after curative resection of gallbladder cancer with hilar invasion is similar to that of hilar cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2012 May;19(3):274–80. Nasu Y, Hirano S, Tsuchikawa T, Shichinohe T. Aggressive surgery for locally advanced gallbladder cancer with obstructive jaundice: result of a prospective study. Dig Surg. 2016;33(3):213–9. Miyazaki M, Yoshitomi H, Miyakawa S, Uesaka K, Unno M, Endo I, et al. Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition. J Hepatobiliary Pancreat Sci. 2015 Apr;22(4):249–73. Farges O, Regimbeau JM, Fuks D, Le Treut YP, Cherqui D, Bachellier P, et al. Multicentre European study of preoperative biliary drainage for hilar cholangiocarcinoma. Br J Surg. 2013 Jan;100(2):274–83. Tamada K, Ido K, Ueno N, Kimura K, Ichiyama M, Tomiyama T. Preoperative staging of extrahepatic bile duct cancer with intraductal ultrasonography. Am J Gastroenterol. 1995 Feb;90(2):239–46. Tamada K, Tomiyama T, Wada S, Ohashi A, Satoh Y, Ido K, et al. Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures. Gut. 2002 Mar;50(3):326–31. Kawakami H, Kuwatani M, Onodera M, Haba S, Eto K, Ehira N, et al. Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma. J Gastroenterol. 2011 Feb;46(2):242–8. Hirano S, Tanaka E, Tsuchikawa T, Matsumoto J, Kawakami H, Nakamura T, et al. Oncological benefit of preoperative endoscopic biliary drainage in patients with hilar cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2014 Aug;21(8):533–40. Chaudhary RJ, Higuchi R, Nagino M, Unno M, Ohtsuka M, Endo I, et al. Survey of preoperative management protocol for perihilar cholangiocarcinoma at 10 Japanese high-volume centers with a combined experience of 2,778 cases. J Hepatobiliary Pancreat Sci. 2019 Nov;26(11):490–502. Kawakubo K, Kawakami H, Kuwatani M, Haba S, Kudo T, Taya YA, et al. Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma. World J Gastrointest Endosc. 2016 May 10;8(9):385–90. Nakai Y, Yamamoto R, Matsuyama M, Sakai Y, Takayama Y, Ushio J, et al. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study. J Gastroenterol Hepatol. 2018 May;33(5):1146–53. Jo JH, Chung MJ, Han DH, Park JY, Bang S, Park SW, et al. Best options for preoperative biliary drainage in patients with Klatskin tumors. Surg Endosc. 2017 Jan;31(1):422–9. Sugiura R, Kuwatani M, Kato S, Kawakubo K, Kamachi H, Taketomi A, et al. Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction. J Hepatobiliary Pancreat Sci. 2020 Nov;27(11):851–9. Kobayashi N, Watanabe S, Hosono K, Kubota K, Nakajima A, Kaneko T, et al. Endoscopic inside stent placement is suitable as a bridging treatment for preoperative biliary tract cancer. BMC Gastroenterol. 2015 Feb 5;15:8. Kubota K, Hasegawa S, Iwasaki A, Sato T, Fujita Y, Hosono K, et al. Stent placement above the sphincter of Oddi permits implementation of neoadjuvant chemotherapy in patients with initially unresectable Klatskin tumor. Endosc Int Open. 2016 Apr;4(4):E427–33. Inatomi O, Bamba S, Shioya M, Mochizuki Y, Ban H, Tsujikawa T, et al. Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction. BMC Gastroenterol. 2013 Feb 14;13:31. Kiriyama S, Kozaka K, Takada T, Strasberg SM, Pitt HA, Gabata T, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17–30. Cotton PB, Eisen GM, Aabakken L, Baron TH, Hutter MM, Jacobson BC, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010 Mar;71(3):446–54. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):41–54. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013 Mar;48(3):452–8. Takahashi Y, Sasahira N, Sasaki T, Inoue Y, Mise Y, Sato T, et al. The role of stent placement above the papilla (inside-stent) as a bridging therapy for perihilar biliary malignancy: an initial experience. Surg Today. 2021;51(11):1795–804. Article / Publication Details

First-Page Preview

Abstract of Research Article

Received: August 03, 2021
Accepted: December 13, 2021
Published online: January 26, 2022

Number of Print Pages: 12
Number of Figures: 5
Number of Tables: 6

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: https://www.karger.com/DIG

留言 (0)

沒有登入
gif