Comparison of the preoperative transpapillary unilateral biliary drainage methods for the future remnant liver in patients with hilar cholangiocarcinoma with liver resection: A retrospective cross-sectional study-Reference-Cited by-同舟云学术

Comparison of the preoperative transpapillary unilateral biliary drainage methods for the future remnant liver in patients with hilar cholangiocarcinoma with liver resection: A retrospective cross-sectional study

Published:2024-06-25 Issue: Volume: Page:
ISSN:
Container-title:
language:
Short-container-title:

Author:

Okuno Mitsuru¹,Iwata Keisuke¹,Iwashita Takuji²,Mukai Tsuyoshi¹,Shimojo Kota¹,Ohashi Yosuke²,Iwasa Yuhei¹,Senju Akihiko²,Iwata Shota²,Tezuka Ryuichi¹,Ichikawa Hironao²,Mita Naoki²,Uemura Shinya²,Yoshida Kensaku³,Maruta Akinori³,Tomita Eiichi¹,Yasuda Ichiro⁴,Shimizu Masahito²

Affiliation:

1. Gifu Municipal Hospital

2. Gifu University Hospital

3. Gifu Prefecture General Medical Center

4. University of Toyama

Abstract

Background and Aims: Transpapillary preoperative biliary drainage (PBD) only for the future remnant liver (FRL) in hilar cholangiocarcinoma (HCCA) can be performed minimally invasively, with the expectation of swelling of the FRL. However, verification of the appropriate transpapillary unilateral PBD method for FRL is limited since the cases of liver resection are insufficient. Methods: A total of 63 patients with resectable HCCA were evaluated. Twelve unilateral across-the-papilla plastic stent placement cases (PS group), 14 unilateral intraductal plastic stent placement cases (IS group), and 11 unilateral endoscopic nasobiliary drainage cases (ENBD group) met the inclusion criteria. Each group was compared regarding the hospital stay duration for the endoscopic procedure, recurrent biliary obstruction (RBO), time to RBO (TRBO), overall survival (OS), and surgical outcomes. Results: No significant differences were observed in the patient characteristics between the groups. Hospital stay for the endoscopic procedure was significantly longer in the ENBD group (50[33-163]days) than in the PS group (14[2-36]days; P<0.01) or IS group (21[6-118]days; P<0.01). There were no significant differences in the RBO, TRBO, OS, surgical time, amount of intraoperative blood loss, or post-surgical adverse events (AEs) between the groups. In the multivariate analysis, there were no significantly related factors for RBO, TRBO, OS, and post-surgical AEs. Conclusions: The PS, IS, and ENBD groups showed similar clinical outcomes in liver resection cases for HCCA, excluding the hospital stay duration for the endoscopic procedure. Considering the hospital stay duration, unilateral PS and IS placement can be considered acceptable for transpapillary PBD. Clinical Trial Registration: UMIN000052598

Publisher

Springer Science and Business Media LLC

Reference18 articles.

1. Banales JM, Marin JJG, Lamarca Aet al.. Cholangiocarcinoma 2020: the next horizon in mechanisms and management Nat Rev Gastroenterol Hepatol. 2020;17:557–588; Antwi SO, Mousa OY, Patel T. Racial, Ethnic, and Age Disparities in Incidence and Survival of Intrahepatic Cholangiocarcinoma in the United States; 1995–2014 Ann Hepatol. 2018;17:604–614.

2. Hasegawa S, Ikai I, Fujii H, Hatano E, Shimahara Y. Surgical resection of hilar cholangiocarcinoma: analysis of survival and postoperative complications World journal of surgery. 2007;31:1256–1263; Hirano S, Tanaka E, Tsuchikawa Tet al.. Oncological benefit of preoperative endoscopic biliary drainage in patients with hilar cholangiocarcinoma Journal of hepato-biliary-pancreatic sciences. 2014;21:533–540.

3. Sakata J, Shirai Y, Tsuchiya Y, Wakai T, Nomura T, Hatakeyama K. Preoperative cholangitis independently increases in-hospital mortality after combined major hepatic and bile duct resection for hilar cholangiocarcinoma Langenbecks Arch Surg. 2009;394:1065–1072; Wiggers JK, Groot Koerkamp B, Cieslak KPet al.. Postoperative Mortality after Liver Resection for Perihilar Cholangiocarcinoma: Development of a Risk Score and Importance of Biliary Drainage of the Future Liver Remnant J Am Coll Surg. 2016;223:321–331.e321; Ribero D, Zimmitti G, Aloia TAet al.. Preoperative Cholangitis and Future Liver Remnant Volume Determine the Risk of Liver Failure in Patients Undergoing Resection for Hilar Cholangiocarcinoma J Am Coll Surg. 2016;223:87–97.

4. Nagino M, Hirano S, Yoshitomi Het al.. Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition Journal of hepato-biliary-pancreatic sciences. 2021;28:26–54.

5. Nakai Y, Yamamoto R, Matsuyama Met al.. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study Journal of gastroenterology and hepatology. 2018;33:1146–1153; Kawashima H, Itoh A, Ohno Eet al.. Preoperative endoscopic nasobiliary drainage in 164 consecutive patients with suspected perihilar cholangiocarcinoma: a retrospective study of efficacy and risk factors related to complications Annals of surgery. 2013;257:121–127; Kawakami H, Kuwatani M, Onodera Met al.. Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma Journal of gastroenterology. 2011;46:242–248.