Endoscopic Biliary Drainage Versus Percutaneous Transhepatic Biliary Drainage in Patients with Resectable Hilar Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Junguo, Liu; Wu, Jing; Wang, Jun; Shu, Guiming; Wang, Yijun; Lü, Cheng; Zhang, Jinjuan; Zhi, Du

doi:10.1089/lap.2017.0744

Cited by 54 publications

(36 citation statements)

References 28 publications

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“…Recent meta-analyses comparing the endoscopic biliary drainage with percutaneous transhepatic approach have found that patients received mainly an endoscopic drainage (52% -63.5%) (36;63;64). However, the percutaneous approach was associated with significantly decreased morbidity rates, including cholangitis and acute pancreatitis (36,39,64). No differences of liver failure, hemorrhage and overall survival rates were observed between the groups (39,(63)(64)(65).…”

Section: Discussion Discussionmentioning

confidence: 98%

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Dumitraşcu¹,

Brasoveanu²,

Stroescu³

et al. 2018

SGO

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Introduction:The knowledge of current approach and outcomes of curative-intent surgery for perihilar cholangiocarcinoma (PHC) has been highlighted in studies of the literature including mainly East Asian and Western patients. Thus, papers presenting the curative-intent surgery in East Europe are scarce. The study aims to present the operative management and outcomes of curative-intent surgery for PHC in an East European institutional experience. Patients and methods: The data of all patients with curative-intent surgery for PHC between 1996 and 2017 were retrospectively reviewed from a prospective maintained electronic database at our Department of Surgery. The assessment was made for the operative management and early and late outcomes. Results: Liver resections were performed in 80.7% of patients, with caudate lobectomies in 64.7% of cases. Vascular resections were performed in 19.4% of patients. Preoperative biliary drainage was performed in 26% of patients. Negative resection margins were obtained in 76.7% of patients. Overall and severe morbidity rates were 57.3% and 24%, respectively. Postoperative bile leak, liver failure and hemorrhage rates were 31.3%, 24.7% and 10%, respectively. The 90-day mortality rate was 6%. The median overall and disease-free survival times were 26 months and 21 months, respectively. Conclusion: The standard approach for curative-intent surgery for PHC implies bile duct resection associated with major hepatectomies, including caudate lobectomy. Expertise in referral surgical centers of East Europe is associated with morbidity, mortality and overall survival rates comparable with those reported in Western centres, despite low rate of preoperative biliary drainage and no use of portal vein embolization. Improvements of preoperative optimization with portal vein embolization and biliary drainage may potentially lead to better early and long-term outcomes.

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Section: Discussion Discussionmentioning

confidence: 98%

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Dumitraşcu¹,

Brasoveanu²,

Stroescu³

et al. 2018

SGO

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“…Transpapillary stent placement with endoscopic retrograde cholangiopancreatography has been the preferred treatment modality for the palliation of malignant distal biliary obstruction [3,19]. However, the performance in patients with resectable tumors is unclear.…”

Section: Endoscopic Biliary Drainagementioning

confidence: 99%

“…Success rates of the initial procedure ranged from 24 to 78%. Although the discomfort of the patient is imposed by nasal drainage, endoscopic nasobiliary drainage is a better way to improve the durability and reduce cholangitis than endobiliary stenting [3].…”

Section: Advantagesmentioning

confidence: 99%

“…Malignant obstructive jaundice is a common condition caused by various adenocarcinomas, including cholangiocarcinoma [1][2][3][4][5][6][7]. Hilar cholangiocarcinoma, which is also known as Klatskin's tumor, accounts for about 50% of cholangiocarcinoma cases [3,8]. Due to the silent tumor growth, curative resection is often not suitable at diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these apparent advantages of performing a preoperative biliary drainage, the safety of the conventional preoperative biliary drainage has not been widely acknowledged, and the benefit remains controversial [3,14]. Endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) are the two preoperative biliary drainage procedures available [2,15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative Biliary Drainage: Methods, Advantages, and Complications

Ángel¹,

Santiago²

2019

Bile Duct Cancer

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Malignant biliary obstruction is very difficult to treat; only 10-20% of the patients are suitable for curative resections. Obstructive jaundice is associated with a pro-inflammatory state, altering the normal physiology and affecting multiple organ systems. So, patients with malignant obstructive jaundice are at increased risk of postoperative complications. Nevertheless, the preoperative biliary drainage (PBD) remains controversial, because the procedures themselves can be associated with septic and other complications. The main therapeutic options for PBD in malignant biliary obstruction are percutaneous biliary drainage and endoscopic biliary drainage. The knowledge of the approaches, their advantages, and complications are essential for the management of patients with pathologies that produce biliary obstruction such as bile duct cancer. The aim of this chapter is to review the methods for biliary drainage and its indications, advantages, and complications.

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Vascular surgery in liver resection

Radulova-Mauersberger

Weitz

Riediger

2021

Langenbecks Arch Surg

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Vascular surgery in liver resection is a standard part of liver transplantation, but is also used in oncological liver surgery. Malignant liver tumors with vascular involvement have a poor prognosis without resection. Surgery is currently the only treatment to provide long-term survival in advanced hepatic malignancy. Even though extended liver resections are increasingly performed, vascular involvement with need of vascular reconstruction is still considered a contraindication for surgery in many institutions. However, vascular resection and reconstruction in liver surgery—despite being complex procedures—are safely performed in specialized centers. The improvements of the postoperative results with reduced postoperative morbidity and mortality are a result of rising surgical and anesthesiological experience and advancements in multimodal treatment concepts with preconditioning measures regarding liver function and systemic treatment options. This review focuses on vascular surgery in oncological liver resections. Even though many surgical techniques were developed and are also used during liver transplantation, this special procedure is not particularly covered within this review article. We provide a summary of vascular reconstruction techniques in oncological liver surgery according to the literature and present also our own experience. We aim to outline the current advances and standards in extended surgical procedures for liver tumors with vascular involvement established in specialized centers, since curative resection improves long-term survival and shifts palliative concepts to curative therapy.

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Endoscopic Biliary Drainage Versus Percutaneous Transhepatic Biliary Drainage in Patients with Resectable Hilar Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Cited by 54 publications

References 28 publications

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Preoperative Biliary Drainage: Methods, Advantages, and Complications

Vascular surgery in liver resection

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