Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction

Sasahira, Naoki; Hamada, Tsuyoshi; Togawa, Osamu; Yamamoto, Ryōichi; Iwai, Tomohisa; Tamada, Kiichi; Kawaguchi, Yoshindo; Sakai, Kenji; Koike, Toshiyuki; Yoshida, Yu; Sugimori, Kazuya; Ryozawa, Shomei; Kakimoto, Toshiharu; Nishikawa, Ko; Kitamura, Katsuya; Imamura, Tsunao; Mizuide, Masafumi; Toda, Nobuo; Maetani, Iruru; Sakai, Yuji; Itoi, Takao; Nagahama, Masatsugu; Nakai, Yousuke; Isayama, Hiroyuki

doi:10.3748/wjg.v22.i14.3793

Cited by 35 publications

(33 citation statements)

References 29 publications

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“…Three studies [8–9,11] reported that ENBD decreased the incidence of preoperative cholangitis before standard resection or palliative surgery compared with EBS, while no significant association was reported in 4 studies. [10,12–14] Moderate heterogeneity ( I 2 = 31%, P = 0.19) was found, so we chose a random-effect model to pool the OR. Overall, the pooled data demonstrated that ENBD was associated with a low incidence of preoperative cholangitis (OR = 0.35, 95% CI = 0.25–0.51, P < 0.0001) in the MBO patients (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Data from 5 articles, [8–10,12–13] including 367 cases in the ENBD group and 381 cases in the EBS group, were used in this meta-analysis. All 5 studies reported that there was no significant difference in the incidence of preoperative pancreatitis between the ENBD and EBS groups.…”

Section: Resultsmentioning

confidence: 99%

“…Five of the 7 studies, [8,9,12–14] including 362 cases in the ENBD group and 386 cases in the EBS group, reported a stent dysfunction rate. Three studies [8,12,13] reported that ENBD reduced the incidence of preoperative stent dysfunction compared with EBS, but the results from 2 studies, [9,14] showed little statistical difference.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [8,12,13] reported that ENBD reduced the incidence of preoperative stent dysfunction compared with EBS, but the results from 2 studies, [9,14] showed little statistical difference. Low heterogeneity ( I 2 = 1%, P = 0.40) was found, so we chose a fixed-effect model to pool the OR.…”

Section: Resultsmentioning

confidence: 99%

“…[12,13] Another advantage of EBS is the absence of discomfort in the pharynx and nasal cavities compared with ENBD. Son et al [27] reported that a short-duration treatment was more appropriate in patients with periampullary cancer and was associated with fewer preoperative complications.…”

Section: Discussionmentioning

confidence: 99%

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The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction

Lin

Liu

2016

Medicine

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction

Lin

Liu

2016

Medicine

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Efficacy of 6‐mm diameter fully covered self‐expandable metallic stents in preoperative biliary drainage for pancreatic ductal adenocarcinoma

et al. 2021

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Objectives Plastic stents (PS) used for preoperative biliary drainage (PBD) of pancreatic ductal adenocarcinomas (PDAC) tend to be associated with a high incidence of recurrent biliary obstruction (RBO). Although 10‐mm diameter fully covered self‐expanding metallic stents (FCSEMS) have come into use, vigilance is still required to prevent complications, such as cholecystitis and surgical site infection. The present study examined the efficacy and safety of the 6‐mm diameter FCSEMS for PBD. Methods The present retrospective study compared the incidence of complications associated with the use of 6‐mm FCSEMS and PS. The inclusion criteria were a diagnosis of PDAC and preoperative endoscopic biliary tract drainage performed at our institution between April 2012 and June 2019. Results Of the 51 patients enrolled, 25 and 26 patients received a PS and a 6‐mm FCSEMS, respectively. The RBO incidence was significantly lower in the 6‐mm FCSEMS group (7.7%) than in the PS group (40.0%) ( p = 0.009), and time to RBO was significantly longer in the 6‐mm FCSEMS group (HR = 6.008, p = 0.021). The patency rate at three months after stent placement was significantly higher in the latter group (83.5% vs. 45.3%, p = 0.009, Log‐rank test). The groups did not differ significantly in terms of complications associated with PBD, such as cholecystitis and surgical site infection. Conclusion The present findings suggested that the 6‐mm FCSEMS may be an effective drainage device for use in PBD in PDAC treatment.

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Preoperative risk factors for skeletal muscle mass loss in patients with biliary tract cancer

Sugiura,

Kuwatani,

Kawakubo

et al. 2024

J Hepato Biliary Pancreat

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BackgroundEndoscopic retrograde cholangiography (ERC)‐related procedures, usually performed before biliary tract cancer (BTC) surgery, are associated with increased risk for various complications, which can cause sarcopenia. No study has previously elucidated the relationship between preoperative ERC‐related procedures and sarcopenia/skeletal muscle mass loss.MethodsPatients with BTC who underwent radical surgical resection following ERC‐related procedures were included. Skeletal muscle mass was evaluated using the psoas muscle mass index (PMI), which was determined using computed tomography images, and the change in PMI before the initial pre‐ERC and surgery (ΔPMI) was calculated. Risk factors for advanced skeletal muscle mass loss, defined as a large ΔPMI, were evaluated.ResultsThe study cohort included 90 patients with a median age of 72 (interquartile range, 65–75) years. The median PMI pre‐ERC and surgery was 4.40 and 4.15 cm2/m2, respectively (p < .01). The median ΔPMI was −6.2% (interquartile range, −10.9% to 0.5%). By multivariate analysis, post‐ERC pancreatitis and cholangitis before surgery were independent predictive factors for large PMI loss (odds ratio, 4.57 and 3.18, respectively; p = .03 and p = .02, respectively).ConclusionsSkeletal muscle mass decreases preoperatively in most patients with BTC undergoing ERC. Post‐ERC pancreatitis and cholangitis before surgery were independent risk factors for large skeletal muscle mass loss.

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Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction

Abstract: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored.

Cited by 35 publications

References 29 publications

The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction

The safety and efficacy of nasobiliary drainage versus biliary stenting in malignant biliary obstruction

Efficacy of 6‐mm diameter fully covered self‐expandable metallic stents in preoperative biliary drainage for pancreatic ductal adenocarcinoma

Preoperative risk factors for skeletal muscle mass loss in patients with biliary tract cancer

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