Percutaneous biliary drainage is oncologically inferior to endoscopic drainage: a propensity score matching analysis in resectable distal cholangiocarcinoma

Komaya, Kenichi; Fukami, Yasuyuki; Shimizu, Eiji; Miyake, Hideo; Takara, Daisuke; Wakai, Kenji; Nagino, Masato

doi:10.1007/s00535-015-1140-6

Cited by 34 publications

(22 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in line with other studies that found an increased rate of drainage tract recurrence in PHCC patients receiving PTBD [13,49,52,53]. However, studies investigating the oncological outcomes after different types of PBD showed significantly lower recurrence rates in ENBD patients compared with PTBD patients [54,55]. It has also been shown that cholangitis rates are higher in EBD groups compared with PTBD groups [7,48].…”

Section: Discussionsupporting

confidence: 90%

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Mehrabi

Khajeh

Ghamarnejad

et al. 2020

European Journal of Radiology

View full text Add to dashboard Cite

A systematic review was performed to evaluate the effect of preoperative biliary drainage (PBD) on outcomes after liver resection in perihilar cholangiocarcinoma (PHCC) patients. Method: MEDLINE and Web of Science were searched up to March 2019. All studies assessing morbidity, mortality, or recurrence in patients who received PBD and hepatectomy for PHCC were included. Mantel-Haenszel tests with a random-effects model were used for meta-analysis. Results: Sixteen studies involving 2162 patients were included. PBD was associated with higher major morbidity odds ratio [OR] = 1.51; 95 % confidence interval [CI] = 1.14-2.00). Selecting patients for PBD based on simple selection criteria was associated with significantly higher major morbidity (OR = 1.57; 95 % CI = 1.10-2.25). In contrast, selecting patients for PBD according to strict criteria resulted in lower major morbidity compared with patients without PBD (OR = 0.51; 95 % CI = 0.18-1.42). PBD did not influence mortality (OR = 1.06; 95 % CI = 0.70-1.61). Tumor recurrence was significantly higher in the PBD group (OR = 2.07; 95 % CI = 1.38-3.11). To decrease PBD-related complications, the duration between PBD and hepatectomy should be shorter than two weeks. Most reports described PBD on the future liver remnant side. Conclusions: Routine PBD cannot be recommended but it may be useful in highly selected patients suffering from cholangitis, malnutrition, and long lasting jaundice, for whom an extended hepatectomy is planned. However, However, routine PBD cannot be recommended due to higher morbidity rate after hepatectomy clear patient selection criteria can be defined for PBD in future multicenter randomized controlled studies.

show abstract

Section: Discussionsupporting

confidence: 90%

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Mehrabi

Khajeh

Ghamarnejad

et al. 2020

European Journal of Radiology

View full text Add to dashboard Cite

show abstract

“…Furthermore, multivariate analysis demonstrated that preoperative PTBD was one of the risk factors for peritoneal recurrence (Table S4). Previous studies have reported similar observations in patients with cholangiocarcinoma and pancreatic cancer . Koyama et al .…”

Section: Discussionsupporting

confidence: 71%

“…Koyama et al . investigated 376 patients with DCC and found that the incidence of peritoneal recurrence was 20.1% in the PTBD group and 7.0% in the EBD group ( P < 0.001) . Uemura et al .…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative percutaneous transhepatic biliary drainage on post‐operative survival in patients with distal cholangiocarcinoma

Mori

Aoki

Park

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: The aim of this study was to investigate the long-term impact of the type of preoperative biliary drainage used for patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma (DCC). Methods: A total of 84 patients with DCC who underwent preoperative biliary drainage between June 2000 and December 2016 were divided into groups for whom percutaneous transhepatic biliary drainage (PTBD) (n = 24) or endoscopic biliary drainage (EBD) (n = 60) was used. Results: The 5-year overall survival in the PTBD group was significantly worse than that in the EBD group (16.7% versus 52.3%, P = 0.007). After propensity score matching (22 patients in each group), the 5-year overall survival in the PTBD group was still worse than that in the EBD group (13.6% versus 61.2%, P = 0.003). Multivariate analysis revealed that PTBD was independent risk factor for both poor survival (P = 0.028) and peritoneal recurrence (P = 0.018). The incidence of multiple sites at initial recurrence tended to be higher in the PTBD group than in the EBD group (P = 0.080). Conclusions: PTBD should not be performed for patients undergoing pancreatoduodenectomy for DCC, except when EBD is contraindicated, as PTBD is significantly associated with shorter survival and peritoneal recurrence.

show abstract

“…PTBD is also accompanied by a higher incidence rate of metastasis, which is an important complication. It has been reported that PTBD increases the incidence of metastasis after resection of distal cholangiocarcinoma and may shorten postoperative survival [ 14 – 16 ]. However, there are no comparison data available among the selected articles, which are suitable for meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis

et al. 2017

View full text Add to dashboard Cite

BackgroundMalignant obstructive jaundice is a common problem in the clinic. Currently, the generally applied treatment methods are percutaneous transhepatic biliary drainage (PTBD) and endoscopic biliary drainage (EBD). Nevertheless, there has not been a uniform conclusion published on either efficacy of the two types of drainage or the incidence rate of complications. Therefore, we conducted a systematic review and meta-analysis of studies comparing endoscopic versus percutaneous biliary drainage in malignant obstructive jaundice, to determine whether there is any difference between percutaneous and endoscopic biliary drainage, with respect to efficacy and incidence rate of overall complications.MethodsThe enrolled studies contain a total of three randomized controlled trials and eleven retrospective studies, which together encompass 2246 patients with PTBD and 8100 patients with EBD.ResultsOur analysis indicates that there is no difference between PTBD and EBD with regard to therapeutic success rate (%), overall complication (%), intraperitoneal bile leak, 30-day mortality, sepsis, or duodenal perforation (%). Cholangitis and pancreatitis after PTBD were lower than after EBD, with odds ratios (OR) of 0.48 (95% confidence interval (CI), 0.31 to 0.74) and 0.16 (95% CI, 0.05 to 0.52), respectively. Incidences of bleeding and tube dislocation for PTBD were higher than EBD, OR of 1.81 (95% CI, 1.35 to 2.44) and 3.41 (95% CI, 1.10 to 10.60).ConclusionsThis meta-analysis indicates certain advantages for both PTBD and EBD. In the clinical practice, it is advised to choose specifically either PTBD or EBD, based on location of obstruction, purpose of drainage (as a preoperative procedure or a palliative treatment) and level of experience in biliary drainage at individual treatment centers.

show abstract

Percutaneous biliary drainage is oncologically inferior to endoscopic drainage: a propensity score matching analysis in resectable distal cholangiocarcinoma

Abstract: Compared with EBD, PTBD increases the incidence of seeding metastasis after resection for distal cholangiocarcinoma and shortens postoperative survival.

Cited by 34 publications

References 38 publications

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Impact of preoperative percutaneous transhepatic biliary drainage on post‐operative survival in patients with distal cholangiocarcinoma

Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: a systematic review and meta-analysis

Contact Info

Product

Resources

About