Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review

Moole, Harsha; Dharmapuri, Sirish; Duvvuri, Abhiram; Dharmapuri, Sowmya; Boddireddy, Raghuveer R.; Moole, Vishnu; Yedama, Prathyusha; Bondalapati, Naveen; Uppu, Achuta; Yerasi, Charan

doi:10.1155/2016/4726078

Cited by 82 publications

(74 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As stated in our paper, we agree that percutaneous transhepatic biliary drainage (PTBD) often results in decreased bilirubin levels [1] and our findings match those of the referenced papers [2][3][4][5]. However, our paper examines the efficacy of PTBD in achieving a goal of a particular bilirubin level.…”

supporting

confidence: 81%

Response to Letter

Khosla

Toomay

2017

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

We thank the writers for their letter regarding our paper, ''Predicting Success in Percutaneous Transhepatic Biliary Drainage.'' As stated in our paper, we agree that percutaneous transhepatic biliary drainage (PTBD) often results in decreased bilirubin levels [1] and our findings match those of the referenced papers [2][3][4][5]. However, our paper examines the efficacy of PTBD in achieving a goal of a particular bilirubin level. For our study, we evaluated achieving levels less than 2 mg/dL as this is required for many chemotherapeutic regimens. The data suggest that certain patient populations are less likely to achieve a bilirubin less than 2 mg/dL despite successful PTBD placement. This does not mean that PTBD should no longer be performed nor do we doubt its efficacy in certain clinical settings. It is our hope that information on the likely decrease in bilirubin post-PTBD will allow patients and referring providers to better weigh the risks and benefits of the procedure. We agree with the letter writers that further studies are needed and data from other institutions to make the model more robust. Compliance with Ethical StandardsConflict of interest The authors declare that they have no conflict of interest. References1. Khosla A, Xi Y, Toomay S. Predicting success in percutaneous transhepatic biliary drainage.

show abstract

supporting

confidence: 81%

Response to Letter

Khosla

Toomay

2017

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

“…Both these studies included all the patients with locally advanced GBC and not exclusively those with jaundice. In patients with obstructive jaundice, chemotherapy often mandates prior biliary drainage and percutaneous transhepatic drainage is an effective treatment option . Postprocedure leak, bleeding, cholangitis, and pancreatitis could complicate biliary drainage procedures and, hence, the time to chemotherapy and the intended curative surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Dasari

Ionescu

Pawlik

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

Introduction Preoperative jaundice is considered a relative contraindication to radical gallbladder cancer (GBC) resection due to poor prognosis and high postoperative morbidity. Recent reports have indicated that aggressive surgery may improve long‐term survival for patients with advanced GBC who present with obstructive jaundice. The current systematic review and meta‐analysis aimed to compare postoperative outcomes among jaundiced and non‐jaundiced patients with resectable GBC. Methods An electronic search was performed using several Medical Subject Headings terms: cholecyst, gallbladder, tumor, cancer, carcinoma, adenocarcinoma, neoplasia, neoplasm, jaundice, and icterus. Overall survival after surgery was the primary outcome; resectability and postoperative morbidity were the secondary outcomes. Results Overall survival was shorter among patients who presented with jaundice (Hazard ratio [HR]: 2.21, 95% confidence interval [CI], 1.64‐2.97; P < 0.001). Patients with jaundice were less likely to have resectable disease (odds ratio: 0.27, 95% CI, 0.17‐0.43; P < 0.001). The jaundice group had higher odds of postoperative morbidity, bile‐leak, and posthepatectomy failure versus the non‐jaundiced control group. Conclusions Radical surgery for GBC resection for patients presenting with obstructive jaundice was associated with reduced overall survival and increased postoperative morbidity. Jaundiced patients with advanced GBC should be considered for surgical resection but need careful evaluation and counseling before undertaking extensive surgical resection.

show abstract

“…However, the CSR of ERCP in MHBO is relatively low . The second procedure for BD is PTBD which has a high TSR and also a high CSR . However, the drawback of PTBD is that it requires cumbersome long‐term care with complications .…”

Section: Alternatives To Ceres In Mhbomentioning

confidence: 99%

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Kongkam

Tasneem

Rerknimitr

2019

Digestive Endoscopy

View full text Add to dashboard Cite

Adequate biliary drainage (BD), defined as more than 50% of liver volume drained, is an ideal BD method in patients with advanced and unresectable malignant hilar biliary obstruction (MHBO). Endoscopic retrograde cholangiopancreatography (ERCP) with multi‐segmental BD is technically challenging. ERCP with percutaneous biliary drainage (PTBD) or PTBD alone has cumbersome maintenance of PTBD line and external bag. The utility of EUS‐guided BD (EUS‐BD) has risen significantly over last 5 years mostly in the clinical setting of distal bile duct obstruction. Information on EUS‐BD for malignant hilar biliary obstruction (MHBO) is thus far limited to only two small studies. This review suggests a new concept of a combination of ERCP and EUS‐BD (CERES) for BD in MHBO as a primary BD method whereby ERCP with a single self‐expandable metal stent (SEMS) is placed into either the right or the left intrahepatic bile duct (IHD). If SEMS is placed in the right biliary system, EUS‐guided hepaticogastrostomy (EUS‐HGS) can subsequently be carried out. However, if the stent is placed into the left biliary system, EUS‐guided hepaticoduodenostomy (EUS‐HDS) is done. For MHBO with non‐functioning right lobe of the liver, EUS‐HGS is carried out after failed ERCP, or primary HGS can be carried out in the left lobe of liver. For MHBO with non‐functioning left lobe of the liver, EUS‐HDS is carried out after failed transpapillary stenting of the right lobe by ERCP. Based on our experience, CERES is promising as it can fulfil gaps of both PTBD and ERCP by allowing internal drainage that can circumvent the inconvenience associated with PTBD and offer higher technical success rate compared to ERCP with bilateral SEMS placement.

show abstract

Endoscopic versus Percutaneous Biliary Drainage in Palliation of Advanced Malignant Hilar Obstruction: A Meta-Analysis and Systematic Review

Cited by 82 publications

References 55 publications

Response to Letter

Response to Letter

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Combination of endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography‐guided biliary drainage in malignant hilar biliary obstruction

Contact Info

Product

Resources

About