Long-Term Results of Percutaneous Transhepatic Biliary Drainage for Benign and Malignant Bile Duct Strictures

Born, Peter; Rösch, T; Triptrap, A; Frimberger, E; Allescher, H. D.; Ott, Raffael; Weigert, N.; Lorenz, Richard; Classen, Meinhard

doi:10.1080/00365529850172142

Cited by 53 publications

(9 citation statements)

References 9 publications

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“…Long-term PTBD is a valid alternative to surgery in patients with malignant bile duct strictures in whom endoscopic drainage has failed. Born et al [27] reported that there are frequently minor problems, mostly catheter-related, which require premature exchange of the drain in almost a half of the cases although PTBD was highly effective in relieving jaundice. Of the 157 PTBD exchanges, 73 (47%) had to be carried out earlier than scheduled.…”

Section: Drainagementioning

confidence: 99%

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

Minami

Kudo²

2012

Dig Dis

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Among patients with later stage hepatocellular carcinoma (HCC), only 1–12% manifest obstructive jaundice as the initial complaint. Endoscopic retrograde biliary drainage (ERBD) and percutaneous transhepatic biliary drainage (PTBD) are the two main non-surgical treatment options for obstructive jaundice in patients with HCC. ERBD is usually the first-line treatment because of its low hemorrhage risk. Some have reported that the successful drainage rate ranges from 72 to 100%. Mean stent patency time and mean survival range from 1.0 to 15.9 and 2.8 to 12.3 months, respectively. PTBD is often an important second-line treatment when ERBD is impossible. With regard to materials, metallic stents offer the benefit of longer patency than plastic stents. The dominant effect of biliary drainage suggests that successful jaundice therapy could enhance anti-cancer treatment by increasing life expectancy, decreasing mortality, or both. We present an overview of the efficacy of endoscopic and percutaneous drainage for obstructive jaundice in patients with HCC who are not candidates for surgical resection and summarize the current indications and outcomes of reported clinical use.

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Section: Drainagementioning

confidence: 99%

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

Minami

Kudo²

2012

Dig Dis

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“…Stent, the main method for biliary drainage, can be used as a palliative treatment against jaundice or a preoperative intervention to ameliorate functions of future remnant liver (17). Compared with percutaneous drains, stent implantation provides a better quality of life without a drainage tube, making it important in treating CCA (18). Notably, even with many studies on carcinogenic mechanisms and signaling pathways, targeted therapies were not found in the research foci of the treatment management cluster, which might be caused by its early stage of development.…”

Section: Discussionmentioning

confidence: 99%

A Bibliometric Analysis of 8,276 Publications During the Past 25 Years on Cholangiocarcinoma by Machine Learning

2021

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IntroductionCholangiocarcinoma (CCA) is the second most common hepatic malignancy. Progress and developments have also been made in the field of CCA management along with increasing scientific publications during the past decades, which reflect topics of general interest and suggest the future direction of studies. The purpose of this bibliometric study is to summarize scientific publications during the past 25 years in the field of CCA using a machine learning method.Material and MethodsScientific publications focusing on CCA from 1995 to 2019 were searched in PubMed using the MeSH term “cholangiocarcinoma.” Full associated data were downloaded in the format of PubMed and extracted in the R platform. Latent Dirichlet allocation (LDA) was adopted to identify the research topics from the abstract of each publication using Python.ResultsA total of 8,276 publications related to CCA from the last 25 years were found and included in this study. The most type of publications remained little changed, while the proportion of clinical trials remained relatively low (7.24% as the highest) and, more significantly, with a further downward trend during the recent years (1.42% in 2019). Neoplasm staging, hepatectomy, and survival rate were the most concerning terms among those who are diagnosis-related, treatment-related, and prognosis-related. The LDA analyses showed chemotherapy, hepatectomy, and stent as the highly concerned research topics of CCA treatment. Meanwhile, conversions from basic studies to clinical therapies were suggested by a poor connection between clusters of treatment management and basic research.ConclusionThe number of publications of CCA has increased rapidly during the past 25 years. Survival analysis, differential diagnosis, and microRNA expression are the most concerned topics in CCA studies. Besides, there is an urgent need for high-quality clinical trials and conversions from basic studies to clinical therapies.

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“…Almost all extrahepatic CCA patients present with biliary obstruction and require stent placement. The rate of infection in malignant obstruction is reported to be anywhere from 20–40% [ 3 , 4 ]. The ABC-02 study reported an infection rate of 19% [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Guidelines for Management of Urgent Symptoms in Patients with Cholangiocarcinoma and Biliary Stents or Catheters Using the Modified RAND/UCLA Delphi Process

Iyer

Acquisto

Bridgewater

et al. 2020

Cancers

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Background: Patients with cholangiocarcinoma often have indwelling biliary stents or catheters which are prone to obstructions and/or infections; studies show that 20–40% present with fever and/or jaundice requiring urgent treatment in the outpatient setting for which there are no uniform guidelines. The goal was to develop an expert panel consensus on this topic using the modified RAND/UCLA Delphi process to rate treatment appropriateness. Methods: Thirteen expert physicians from relevant specialties, geography, and practice settings were recruited for the panel. Patient scenarios were developed and panelists rated the therapies before and after a face-to-face discussion. The appropriateness of various therapies was rated on a scale from 1–9 and classified as appropriate, inappropriate, or uncertain. Scenarios with greater than 2 (>2) ratings of 1–3 (inappropriate) and greater than 2 (>2) ratings of 7–9 (appropriate) were considered to have disagreement and were not assigned an appropriateness rating. Results: Panelists were from all US regions and the UK (8%) and had practiced for a mean 16.5 years (4–33 years). Panelists rated 480 scenarios before the meeting and re-rated 288 of the clinical scenarios after the meeting. The panelists agreed that ongoing treatment with chemotherapy did not influence decision-making and, therefore, 192 scenarios were excluded from the final list. Disagreement decreased from 37.5% before to 10.4% after the meeting. Consensus on stent/tube manipulation and inpatient antibiotic therapy was obtained and summarized in patients as “appropriate” or “maybe appropriate” based on a patient’s bilirubin level at presentation. Conclusions: The Delphi process produced consensus guidelines to fill an unmet need in the urgent management of ascending cholangitis in patients with cholangiocarcinoma.

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Long-Term Results of Percutaneous Transhepatic Biliary Drainage for Benign and Malignant Bile Duct Strictures

Cited by 53 publications

References 9 publications

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

Hepatocellular Carcinoma with Obstructive Jaundice: Endoscopic and Percutaneous Biliary Drainage

A Bibliometric Analysis of 8,276 Publications During the Past 25 Years on Cholangiocarcinoma by Machine Learning

Guidelines for Management of Urgent Symptoms in Patients with Cholangiocarcinoma and Biliary Stents or Catheters Using the Modified RAND/UCLA Delphi Process

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