BACKGROUND AND OBJECTIVES: The aim of this study was to determine the impact of preoperative biliary drainage (PBD) on long-term survival in patients with pancreatic head carcinoma after surgical resection. METHODS: Medical records of 160 patients with pancreatic head carcinoma who underwent surgical resection were reviewed retrospectively. Clinicopathological parameters including long-term survival were compared between patients who did and did not undergo PBD. RESULTS: Overall survival of patients who underwent PBD (n = 93) was significantly worse than that of patients who did not (n = 67) by univariate analysis (P = 0.030). However, multivariate analysis revealed that PBD was not an independent prognostic factor for overall survival (P = 0.227). Patients who underwent percutaneous transhepatic biliary drainage (PTBD) had significantly worse survival than patients who underwent endoscopic retrograde biliary drainage (ERBD, P = 0.038) and patients who did not undergo PBD (P = 0.001). The rate of peritoneal recurrence in patients who underwent PTBD was significantly higher than that of patients who underwent ERBD (P = 0.033) or patients who did not undergo PBD (P = 0.034). CONCLUSIONS: PBD may not affect the long-term survival of patients with pancreatic head carcinoma if ERBD is used.
BACKGROUND AND OBJECTIVES: The aim of this study was to determine the impact of preoperative biliary drainage (PBD) on long-term survival in patients with pancreatic head carcinoma after surgical resection. METHODS: Medical records of 160 patients with pancreatic head carcinoma who underwent surgical resection were reviewed retrospectively. Clinicopathological parameters including long-term survival were compared between patients who did and did not undergo PBD. RESULTS: Overall survival of patients who underwent PBD (n = 93) was significantly worse than that of patients who did not (n = 67) by univariate analysis (P = 0.030). However, multivariate analysis revealed that PBD was not an independent prognostic factor for overall survival (P = 0.227). Patients who underwent percutaneous transhepatic biliary drainage (PTBD) had significantly worse survival than patients who underwent endoscopic retrograde biliary drainage (ERBD, P = 0.038) and patients who did not undergo PBD (P = 0.001). The rate of peritoneal recurrence in patients who underwent PTBD was significantly higher than that of patients who underwent ERBD (P = 0.033) or patients who did not undergo PBD (P = 0.034). CONCLUSIONS: PBD may not affect the long-term survival of patients with pancreatic head carcinoma if ERBD is used.
Authors: Anna Tavakkoli; B Joseph Elmunzer; Akbar K Waljee; Caitlin C Murphy; Sandi L Pruitt; Hong Zhu; Rong Rong; Richard S Kwon; James M Scheiman; Joel H Rubenstein; Amit G Singal Journal: Gastrointest Endosc Date: 2020-06-09 Impact factor: 9.427