Endoscopic nasobiliary drainage versus endoscopic biliary stenting for preoperative biliary drainage in patients with malignant hilar biliary obstruction: Propensity score-matched multicenter comparative study

被引：3

作者：

Ishiwatari, Hirotoshi ^{[1
,18
]}

Kawabata, Takanori ^{[2
]}

Kawashima, Hiroki ^{[4
]}

Nakai, Yousuke ^{[5
]}

Miura, Shin

Kato, Hironari

Shiomi, Hideyuki ^{[10
,11
]}

Fujimori, Nao ^{[12
]}

Ogura, Takeshi ^{[14
]}

Inatomi, Osamu ^{[16
]}

Kubota, Kensuke ^{[17
]}

Fujisawa, Toshio

Takenaka, Mamoru ^{[15
]}

Mori, Hiroshi

Noguchi, Kensaku

Fujii, Yuki ^{[9
]}

Sugiura, Teiichi ^{[3
]}

Ideno, Noboru ^{[13
]}

Nakafusa, Tomoki ^{[13
]}

Masamune, Atsushi ^{[8
]}

Isayama, Hiroyuki ^{[6
]}

Sasahira, Naoki ^{[7
]}

机构：

[1] Shizuoka Canc Ctr, Div Endoscopy, Shizuoka, Japan

[2] Shizuoka Canc Ctr, Clin Res Ctr, Shizuoka, Japan

[3] Shizuoka Canc Ctr, Div Hepatobiliary Pancreat Surg, Shizuoka, Japan

[4] Nagoya Univ Hosp, Dept Endoscopy, Nagoya, Aichi, Japan

[5] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[6] Juntendo Univ, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[7] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastroenterol, Div Hepatobiliary Pancreat Med, Tokyo, Japan

[8] Tohoku Univ, Grad Sch Med, Div Gastroenterol, Sendai, Miyagi, Japan

[9] Okayama Univ, Grad Sch Med & Dent, Dept Gastroenterol & Hepatol, Okayama 7008558, Japan

[10] Kobe Univ, Grad Sch Med, Div Gastroenterol, Dept Internal Med, Kobe, Hyogo, Japan

[11] Hyogo Med Univ, Dept Internal Med, Div Gastroenterol & Hepatobiliary Pancreatol, Nishinomiya, Hyogo, Japan

[12] Kyushu Univ, Grad Sch Med Sci, Dept Med & Bioregulatory Sci, Fukuoka, Japan

[13] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Oncol, Fukuoka, Japan

[14] Osaka Med & Pharmaceut Univ Hosp, Endoscopy Ctr, Osaka, Japan

[15] Kindai Univ, Fac Med, Dept Gastroenterol & Hepatol, Osaka, Japan

[16] Shiga Univ Med Sci, Div Gastroenterol, Dept Med, Otsu, Shiga, Japan

[17] Yokohama City Univ, Grad Sch Med, Div Gastroenterol, Yokohama, Kanagawa, Japan

[18] Shizuoka Canc Ctr, Div Endoscopy, 1007 Shimonagakubo Nagaizumi Cho, Shizuoka 4118777, Japan

来源：

DIGESTIVE ENDOSCOPY | 2024年 / 36卷 / 06期

关键词：

endoscopic biliary stenting; endoscopic nasobiliary drainage; malignant hilar biliary obstruction; perihilar cholangiocarcinoma; preoperative biliary drainage; PERIHILAR CHOLANGIOCARCINOMA; PLASTIC STENT; PLACEMENT; CLASSIFICATION; STRICTURES; SPHINCTER; EFFICACY; ODDI;

D O I：

10.1111/den.14712

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

ObjectivesFor preoperative biliary drainage (PBD) of malignant hilar biliary obstruction (MHBO), current guidelines recommend endoscopic nasobiliary drainage (ENBD) due to the higher risk of cholangitis after endoscopic biliary stenting (EBS) during the waiting period before surgery. However, few studies have supported this finding. Therefore, we aimed to compare the outcomes of preoperative ENBD and EBS in patients with MHBO.MethodsPatients with MHBO who underwent laparotomy for radical surgery after ENBD or EBS were included from retrospectively collected data from 13 centers (January 2014 to December 2018). We performed a 1:1 propensity score matching between the ENBD and EBS groups. These patients were compared for the following: cholangitis and all adverse events (AEs) after endoscopic biliary drainage (EBD) until surgery, time to cholangitis development after EBD, postsurgical AEs, and in-hospital death after surgery.ResultsOf the 414 patients identified, 355 were analyzed in this study (226 for ENBD and 129 for EBS). The matched cohort included 63 patients from each group. The proportion of cholangitis after EBD was similar between the two groups (20.6% vs. 25.4%, P = 0.67), and no significant difference was observed in the time to cholangitis development. The proportions of surgical site infections, bile leaks, and in-hospital mortality rates were similar between the groups.ConclusionFor PBD of MHBO, the proportion of AEs, including cholangitis, after EBD until surgery was similar when either ENBD or EBS was used.

引用

页码：726 / 734

页数：9