Ryo Sugiura1, Masaki Kuwatani1,2, Shin Kato1, Kazumichi Kawakubo1, Hirofumi Kamachi3, Akinobu Taketomi3, Takehiro Noji4, Keisuke Okamura4, Satoshi Hirano4, Naoya Sakamoto1. 1. Department of Gastroenterology and Hepatology, Hokkaido University, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan. 2. Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan. 3. Department of Gastroenterological Surgery I, Hokkaido University, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan. 4. Department of Gastroenterological Surgery II, Hokkaido University, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan.
Abstract
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 28patients (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 90days, respectively (Kaplan-Meier method). The rate of dysfunction of the initial EBD increased in patients with BC-IV (P=0.03). 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. This article is protected by copyright. All rights reserved.
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 28patients (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 90days, respectively (Kaplan-Meier method). The rate of dysfunction of the initial EBD increased in patients with BC-IV (P=0.03). 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. This article is protected by copyright. All rights reserved.
Authors: Gabriel Mayo Vieira de Souza; Igor Braga Ribeiro; Mateus Pereira Funari; Diogo Turiani Hourneaux de Moura; Maria Vitória Cury Vieira Scatimburgo; João Remí de Freitas Júnior; Sergio A Sánchez-Luna; Renato Baracat; Eduardo Turiani Hourneaux de Moura; Wanderley Marques Bernardo; Eduardo Guimarães Hourneaux de Moura Journal: World J Hepatol Date: 2021-05-27