Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E‐POD hilar study

Nakai, Yousuke; Yamamoto, Ryōichi; Sakai, Yuji; Takayama, Yoshiaki; Ushio, Jun; Ito, Yukiko; Kitamura, Katsuya; Ryozawa, Shomei; Imamura, Tsunao; Tsuchida, Kouhei; Hayama, Jo; Itoi, Takao; Kawaguchi, Yoshindo; Yoshida, Yu; Sugimori, Kazuya; Sakai, Kenji; Mizuide, Masafumi; Iwai, Tomohisa; Nishikawa, Ko; Yagioka, Hiroshi; Nagahama, Masatsugu; Toda, Nobuo; Saito, Tomotaka; Yasuda, Ichiro; Hirano, Keisuke; Togawa, Osamu; Nakamura, Kenji; Maetani, Iruru; Sasahira, Naoki; Isayama, Hiroyuki

doi:10.1111/jgh.14050

Cited by 37 publications

(35 citation statements)

References 21 publications

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“…Nakai et al also reported that unplanned re-intervention was associated with a poor prognosis in patients with MHBO resected. 9 The present study showed that the independent predictive factors of dysfunction of initial EBD were BC-IV and pre-EBD cholangitis. Therefore, the patients with such factors should undergo as early radical surgical resection as possible, or bilateral EBD should be considered at an early stage.…”

Section: Discussionsupporting

confidence: 51%

“…There have been several studies that focused on complications caused by EBD and need for re-intervention. [6][7][8][9][10] During the preoperative waiting period, dysfunction of EBD frequently results in the need for biliary re-interventions and postponement of surgery, occasionally leading to abort of surgery due to tumor progression. However, few studies have focused on the risk factors for dysfunction of EBD in patients with MHBO.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Sugiura

Kuwatani

Kato

et al. 2020

J Hepato Biliary Pancreat

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Background: Few studies have focused on the risk factors for dysfunction of endoscopic biliary drainage (EBD) in preoperative patients with malignant hilar biliary obstruction (MHBO). Methods: We searched the database between February 2011 and December 2018 and identified patients with MHBO who underwent radical operation. The rate of dysfunction of the initial EBD, risk factors for dysfunction of the initial EBD and survival after surgery were retrospectively evaluated. Results: We analyzed a total of 131 patients [95 males (72.5%); mean age, 69.5 (±7.3) years; Bismuth-Corlette classification (BC) I/II/IIIa/IIIb/IV, 50/26/22/17/16; hilar cholangiocarcinoma/gall bladder cancer, 115/16]. Dysfunction of the initial EBD occurred in 28 patients (21.4%). The cumulative incidences of dysfunction of the initial EBD in all patients were 18.4%, 38.2% and 47.0% at 30, 60 and 90 days, respectively (Kaplan-Meier method). The rate of dysfunction of the initial EBD increased in patients with BC-IV (P = .03). Multivariate analysis showed that BC-IV and pre-EBD cholangitis were significantly associated with the occurrence of dysfunction of the initial EBD. Survival rates were not significantly different according to the initial biliary drainage methods and presence/absence of the initial EBD dysfunction. Conclusions: Dysfunction of the initial EBD frequently occurs in patients with the BC-IV and those with pre-EBD cholangitis. K E Y W O R D S endoscopic biliary drainage, preoperative biliary drainage, malignant hilar biliary obstruction, hilar cholangiocarcinoma, gall bladder cancer How to cite this article: Sugiura R, Kuwatani M, Kato S, et al. Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Sugiura

Kuwatani

Kato

et al. 2020

J Hepato Biliary Pancreat

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“…From the 9 studies, 813 cases in the ENBD group and 622 cases in the EBS group were used in this metaanalysis [8][9][10][11][12][13][14][15][16]. Low heterogeneity (I 2 = 19%, P = 0.27) was found, so we chose a random-effect model to pool the RR.…”

Section: Incidence Of Preoperative Cholangitismentioning

confidence: 99%

Comparison of effect between nasobiliary drainage and biliary stenting in malignant biliary obstruction: a systematic review and updated meta-analysis

Zhang

Che

2020

World J Surg Onc

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Background: To compare the efficacy of endoscopic nasobiliary drainage (ENBD) and endoscopic biliary stenting (EBS) in preoperative biliary drainage (PBD). Methods: ENBD and EBS related literature of patients with malignant biliary obstruction published before September 2019 were collected from PubMed, EMBASE, and Cochrane Library for comparison analysis. Revman 5.3 statistical software was used for analysis. Results: Nine studies were used for our comparative study. A total of 1435 patients were included, which consisted of 813 in the ENBD group and 622 in the EBS group. Meta-analysis showed that patients with malignant biliary obstruction who received ENBD had reductions in the rates of preoperative cholangitis (RR = 0.46, 95% CI = 0.34-0.62, P < 0.00001), preoperative pancreatitis (RR = 0.69, 95% CI = 0.50-0.95, P = 0.02), stent dysfunction (RR = 0.58, 95% CI = 0.43-0.80, P = 0.0008), morbidity (RR = 0.77, 95% CI = 0.64-0.93, P = 0.007), and postoperative pancreatic fistula (RR = 0.65, 95% CI = 0.45-0.92, P = 0.02) compared with patients who received EBS. Conclusions: The rates of preoperative cholangitis, preoperative pancreatitis, post-operative pancreatic fistula, stent dysfunction, and morbidity of ENBD patients were lower than those of EBS patients. In clinical practice, the physical condition of each patient and their tolerance should be fully considered. ENBD should be given priority. EBS should be replaced if stent dysfunction or intolerance occurs.

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“…On the other hand, the technical rate of success of preoperative ENBD was higher. Its re-intervention rate had not been diminutive and unexpected re-intervention was confederated with a poor prognosis in resected hilar biliary obstruction [50]. Authors quoted that [50]; ENBD for hilar biliary obstruction currently requires re-interventions, equally in the planned and unexpected way.…”

Section: Endoscopic Retrograde Biliary Drainage (Erbd) or Endoscopic mentioning

confidence: 99%

“…Its re-intervention rate had not been diminutive and unexpected re-intervention was confederated with a poor prognosis in resected hilar biliary obstruction [50]. Authors quoted that [50]; ENBD for hilar biliary obstruction currently requires re-interventions, equally in the planned and unexpected way. It would need additional research in order to strengthen safety and efficiency of ENBD in those patients.…”

Section: Endoscopic Retrograde Biliary Drainage (Erbd) or Endoscopic mentioning

confidence: 99%

Perihilar or (Hilar) Cholangiocarcinoma: Interventional to Surgical Management

Prasoon¹,

Miura²,

Yuza³

et al. 2019

Bile Duct Cancer

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Peri-hilar cholangiocarcinoma (PHC) or hilar cholangiocarcinoma (HCCA) characterizes a critical effort to assess significantly sick patients. The existing scenery and proof to the diagnosis and treatments for hilar cholangiocarcinoma are improving day by day. Patients with HCCA encounter numerous obstacles in acquiring efficient therapies. The condition is uncommon, and the majority patients don't have any distinct risk factors, doing selection process inadequate. The initial signs and symptoms in many cases are non-specific, and in many patients the tumors are not resectable because of involvement of the perihilar structures. MRI with MRCP offers further information about the extent of biliary involvement. Furthermore, endoscopic stenting and percutaneous drain could be useful for intricate hilar strictures. Surgical resections with negative margins are related to good likelihood of survival for patients representing with HCCA. Regardless of the accessibility of curative treatment strategies such as operative resection and liver transplantation, most sufferers with HCCA shows with repeated, metastases or locally advanced disease with a poor prognosis. Within this chapter, we have tried to elaborate the modalities of treatment from intervention to surgical approach for HCCA.

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Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E‐POD hilar study

Cited by 37 publications

References 21 publications

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Comparison of effect between nasobiliary drainage and biliary stenting in malignant biliary obstruction: a systematic review and updated meta-analysis

Perihilar or (Hilar) Cholangiocarcinoma: Interventional to Surgical Management

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