Preoperative biliary drainage versus direct surgery for perihilar cholangiocarcinoma: A retrospective study at a single center

Cai, Yulong; Tang, Qi; Xiong, Xian‐Ze; Li, Fuyu; Yang, Hui; Song, Peipei; Cheng, Nan‐Sheng

doi:10.5582/bst.2017.01107

Cited by 19 publications

(23 citation statements)

References 23 publications

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“…Three studies performed routine PBD in all patients [12,19,21] and two performed PBD before liver resection in jaundice patients [22,24]. Kimura et al performed a multicenter study with different indications for PBD; at a center in Hirosaki, patients underwent PBD routinely, whereas at a center in Leeds, only patients with jaundice underwent PBD [23].…”

Section: Simple Criteriamentioning

confidence: 99%

“…PTBD was performed in 700 patients, EBD in 576 patients, and other procedures including surgical drainage, nasobiliary drainage, and/or endoscopic biliary stent in 218 patients. One study did not report which procedure was used for PBD [19].…”

Section: Quantitative Analysismentioning

confidence: 99%

“…Based on this, it is crucial to select the patients who may benefit from PBD before liver resection. Various selection approaches have been reported; some centers routinely perform PBD in all CC patients scheduled for liver resection, others only use PBD in jaundiced patients or multi-morbid patients, and some have a cut-off bilirubin level for PBD [12,16,17,[19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Mehrabi

Khajeh

Ghamarnejad

et al. 2020

European Journal of Radiology

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A systematic review was performed to evaluate the effect of preoperative biliary drainage (PBD) on outcomes after liver resection in perihilar cholangiocarcinoma (PHCC) patients. Method: MEDLINE and Web of Science were searched up to March 2019. All studies assessing morbidity, mortality, or recurrence in patients who received PBD and hepatectomy for PHCC were included. Mantel-Haenszel tests with a random-effects model were used for meta-analysis. Results: Sixteen studies involving 2162 patients were included. PBD was associated with higher major morbidity odds ratio [OR] = 1.51; 95 % confidence interval [CI] = 1.14-2.00). Selecting patients for PBD based on simple selection criteria was associated with significantly higher major morbidity (OR = 1.57; 95 % CI = 1.10-2.25). In contrast, selecting patients for PBD according to strict criteria resulted in lower major morbidity compared with patients without PBD (OR = 0.51; 95 % CI = 0.18-1.42). PBD did not influence mortality (OR = 1.06; 95 % CI = 0.70-1.61). Tumor recurrence was significantly higher in the PBD group (OR = 2.07; 95 % CI = 1.38-3.11). To decrease PBD-related complications, the duration between PBD and hepatectomy should be shorter than two weeks. Most reports described PBD on the future liver remnant side. Conclusions: Routine PBD cannot be recommended but it may be useful in highly selected patients suffering from cholangitis, malnutrition, and long lasting jaundice, for whom an extended hepatectomy is planned. However, However, routine PBD cannot be recommended due to higher morbidity rate after hepatectomy clear patient selection criteria can be defined for PBD in future multicenter randomized controlled studies.

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Section: Simple Criteriamentioning

confidence: 99%

Section: Quantitative Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Mehrabi

Khajeh

Ghamarnejad

et al. 2020

European Journal of Radiology

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“…Cai and co-workers used preoperative biliary drainage in 25.2% of patients and did not find any differences of morbidity and mortality rates between the groups (46). Furthermore, preoperative biliary drainage was associated with significantly increased operative times and hospital stays (46).…”

Section: Discussion Discussionmentioning

confidence: 98%

“…Several studies have explored the outcomes of surgery for PHC with and without preoperative biliary drainage (37,(46)(47)(48)(49)(50)(51)(52).…”

Section: Discussion Discussionmentioning

confidence: 99%

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Dumitraşcu¹,

Brasoveanu²,

Stroescu³

et al. 2018

SGO

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Introduction:The knowledge of current approach and outcomes of curative-intent surgery for perihilar cholangiocarcinoma (PHC) has been highlighted in studies of the literature including mainly East Asian and Western patients. Thus, papers presenting the curative-intent surgery in East Europe are scarce. The study aims to present the operative management and outcomes of curative-intent surgery for PHC in an East European institutional experience. Patients and methods: The data of all patients with curative-intent surgery for PHC between 1996 and 2017 were retrospectively reviewed from a prospective maintained electronic database at our Department of Surgery. The assessment was made for the operative management and early and late outcomes. Results: Liver resections were performed in 80.7% of patients, with caudate lobectomies in 64.7% of cases. Vascular resections were performed in 19.4% of patients. Preoperative biliary drainage was performed in 26% of patients. Negative resection margins were obtained in 76.7% of patients. Overall and severe morbidity rates were 57.3% and 24%, respectively. Postoperative bile leak, liver failure and hemorrhage rates were 31.3%, 24.7% and 10%, respectively. The 90-day mortality rate was 6%. The median overall and disease-free survival times were 26 months and 21 months, respectively. Conclusion: The standard approach for curative-intent surgery for PHC implies bile duct resection associated with major hepatectomies, including caudate lobectomy. Expertise in referral surgical centers of East Europe is associated with morbidity, mortality and overall survival rates comparable with those reported in Western centres, despite low rate of preoperative biliary drainage and no use of portal vein embolization. Improvements of preoperative optimization with portal vein embolization and biliary drainage may potentially lead to better early and long-term outcomes.

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Präoperative Konditionierung bei Lebereingriffen und Transplantationen

Rayes¹,

Seidemann²,

Seehofer³

2022

Präoperative Konditionierung Des Viszeralchirurgischen Risikopatienten

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Preoperative biliary drainage versus direct surgery for perihilar cholangiocarcinoma: A retrospective study at a single center

Cited by 19 publications

References 23 publications

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Meta-analysis of the efficacy of preoperative biliary drainage in patients undergoing liver resection for perihilar cholangiocarcinoma

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Präoperative Konditionierung bei Lebereingriffen und Transplantationen

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