Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma
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概要
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Controversy exists over the preferred technique of preoperative biliary drainage (PBD) in patients with hilar cholangiocarcinoma (HCA). The goal of this retrospective study was to identify the preferred technique of PBD for HCA. A total of 128 consecutive patients with HCA diagnosed between September 1999 and December 2009 who underwent PBD were included in this study. The study compared outcomes of endoscopic nasobiliary drainage (ENBD), endoscopic biliary stenting (EBS), and percutaneous transhepatic biliary drainage (PTBD) in patients with HCA. There were no significant differences in preoperative laboratory data, rates of major hepatectomy, or decompression periods among the 3 groups. Complications were significantly more frequent in the EBS group compared with either the ENBD or PTBD group (p < 0.05). Drainage tube occlusion with cholangitis was significantly more common in the EBS group compared with either the ENBD or PTBD group (p < 0.0001). Patients in the PTBD group experienced serious complications including vascular injury (8%) and cancer dissemination (4%). Patients in the ENBD and EBS groups had mild post-endoscopic retrograde cholangiopancreatography pancreatitis (5%). Conversion procedures were significantly more common in the EBS group compared with the ENBD and PTBD groups (p < 0.05). There was no significant difference in postsurgical morbidity or mortality among the 3 groups. Drainage tube occlusion with cholangitis was a frequent complication associated with EBS. PTBD was associated with serious complications such as vascular injury and cancer dissemination. ENBD was found to be the most suitable method for initial PBD management in patients with HCA.
- 2011-02-01
著者
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Shirato Hiroki
北海道大学 医学研究科耳鼻咽喉科･頭頸部外科学分野
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Kondo Satoshi
斗南病院 外科
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Hirano Satoshi
北海道大学 医学研究科腫瘍外科学分野
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Asaka Masahiro
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
北海道大学 医学研究科消化器内科学
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KAWAKAMI HIROSHI
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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Katoh Hiroyuki
Department Of Surgery Tonan Hospital
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Kondoh Satoshi
Second Department Of Surgery Hokkaido University School Of Medicine
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Sugiura Hiroshi
Department Of Surgical Oncology Division Of Cancer Medicine Hokkaido University Graduate School Of M
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Asaka Masahiro
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
Third Department Of Internal Medicine Hokkaido University Graduate School Of Medicine
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KUWATANI MASAKI
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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ONODERA MANABU
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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HIRANO SATOSHI
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
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Onodera Manabu
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Kondo Satoshi
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Maruta Ichiroh
Department Of Hematology And Oncology Hokkaido University Graduate School Of Medicine
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YAMATO Hiroaki
Department of Internal Medicine, Hakodate Municipal Hospital
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EHIRA Nobuyuki
Department of Internal Medicine, Hakodate Municipal Hospital
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Imamura Masahiro
Department Of Internal Medicine Saiseikai-hita Hospital
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Hirano Satoshi
Department Of Electrical And Computer Engineering Nagoya Institute Of Technology
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Shirato Hiroki
Keiyukai Sapporo Hospital Sapporo Jpn
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Iwahashi Masahiro
Department Of Internal Medicine Saiseikai-hita Hospital
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Asaka Masahiro
Hokkaido Univ. School Of Medicine Sapporo Jpn
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Kanamori Hiroe
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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Saito Katsunori
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Imamura M
Department Of Internal Medicine Saiseikai-hita Hospital
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Kobayashi Hajime
Fourth Department Of Internal Medicine Obihiro Kosei Hospital
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Eto Kazunori
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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Tanaka Eiichi
Department Of Mechanical Engineering Nagoya Univeisity
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Kondo Satoshi
Department Of Chemistry And Chemical Engineering Yamagata University
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HABA SHIN
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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KUDO Taiki
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
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Haba Shin
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Tanaka Eiichi
Department Of Surgical Oncology Hokkaido University Graduate School Of Medicine
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Yamato Hiroaki
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Kuwatani Masaki
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Asaka M
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Hirano Satoshi
Second Department Of Surgery Hokkaido University School Of Medicine
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Eto Kazunori
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Kudo Taiki
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Tanaka Eiichi
Department Of Electrical And Electronics Engineering Kobe University
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Kawakami Hiroshi
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Ehira Nobuyuki
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Tanaka Eiichi
Department Of Applied Physics And Chemistry The University Of Electro-communications
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Kawakami Hiroshi
北海道大学 医学研究科消化器内科
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Shirato Hiroki
Department Of Diagnostic And Interventional Radiology Hokkaido University Hospital
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Kawakami Hiroshi
Department Of Gastroenterology And Hepatology Hokkaido University
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Haba Shin
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Asaka Masahiro
Department Of Cancer Preventive Medicine Graduate School Of Medicine Hokkaido University
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Tanaka Eiichi
Division Of Cancer Diagnostics And Therapeutics Hokkaido University Graduate School Of Medicine
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TANAKA Eiichi
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
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Kawakami Hiroshi
Department of Food Science & Nutrition, Kyoritsu Women's University
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Kawakami Hiroshi
Department of Cardiology, Ehime Prefectural Central Hospital
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