BACKGROUND: The aim of the study was to clarify the incidence, risk factors and treatment of percutaneous transhepatic biliary drainage (PTBD) catheter tract recurrence in patients with resected cholangiocarcinoma. METHODS: The medical records of 445 patients with perihilar and distal cholangiocarcinoma who underwent resection following PTBD were reviewed retrospectively. RESULTS: PTBD catheter tract recurrence was detected in 23 patients (5.2 per cent). The mean(s.d.) interval between surgery and onset of the recurrence was 14.4(13.8) months. On multivariable analysis, duration of PTBD (60 days or more), multiple PTBD catheters and macroscopic papillary tumour type were identified as independent risk factors. In four patients with synchronous metastasis, the PTBD sinus tract was resected simultaneously, at the time of initial surgery. Of 19 patients with metachronous metastasis, 15 underwent surgical resection of the metastasis. Survival of the 23 patients with PTBD catheter tract recurrence was poorer than that of the 422 patients without recurrence (median 22.8 versus 27.3 months; P = 0.095). Even after surgical resection of PTBD catheter tract recurrence, survival was poor. CONCLUSION: PTBD catheter tract recurrence is not unusual. The prognosis for these patients is generally poor, even after resection. To prevent this troublesome complication, endoscopic biliary drainage is first recommended when drainage is indicated.
BACKGROUND: The aim of the study was to clarify the incidence, risk factors and treatment of percutaneous transhepatic biliary drainage (PTBD) catheter tract recurrence in patients with resected cholangiocarcinoma. METHODS: The medical records of 445 patients with perihilar and distal cholangiocarcinoma who underwent resection following PTBD were reviewed retrospectively. RESULTS: PTBD catheter tract recurrence was detected in 23 patients (5.2 per cent). The mean(s.d.) interval between surgery and onset of the recurrence was 14.4(13.8) months. On multivariable analysis, duration of PTBD (60 days or more), multiple PTBD catheters and macroscopic papillary tumour type were identified as independent risk factors. In four patients with synchronous metastasis, the PTBD sinus tract was resected simultaneously, at the time of initial surgery. Of 19 patients with metachronous metastasis, 15 underwent surgical resection of the metastasis. Survival of the 23 patients with PTBD catheter tract recurrence was poorer than that of the 422 patients without recurrence (median 22.8 versus 27.3 months; P = 0.095). Even after surgical resection of PTBD catheter tract recurrence, survival was poor. CONCLUSION: PTBD catheter tract recurrence is not unusual. The prognosis for these patients is generally poor, even after resection. To prevent this troublesome complication, endoscopic biliary drainage is first recommended when drainage is indicated.
Authors: Jae Hyung Lee; You Jin Lee; Jong Yoon Chung; Mi Young Jung; Ji Ho Park; Jong Hee Lee; Joo Heung Lee; Jun Mo Yang; Dong-Youn Lee Journal: Ann Dermatol Date: 2015-03-24 Impact factor: 1.444
Authors: Anthony T Ruys; Simon G Heuts; Eric A Rauws; Olivier R C Busch; Dirk J Gouma; Thomas M van Gulik Journal: HPB (Oxford) Date: 2013-08-26 Impact factor: 3.647
Authors: Jimme K Wiggers; Bas Groot Koerkamp; Robert J Coelen; Erik A Rauws; Mark A Schattner; C Yung Nio; Karen T Brown; Mithat Gonen; Susan van Dieren; Krijn P van Lienden; Peter J Allen; Marc G H Besselink; Olivier R C Busch; Michael I D'Angelica; Robert P DeMatteo; Dirk J Gouma; T Peter Kingham; William R Jarnagin; Thomas M van Gulik Journal: Endoscopy Date: 2015-09-18 Impact factor: 10.093