Impact of preoperative percutaneous transhepatic biliary drainage on post‐operative survival in patients with distal cholangiocarcinoma. Issue 9 (7th July 2019)

• Record Type: Journal Article
• Authors: Mori, Shozo; Aoki, Taku; Park, Kyung‐Hwa; Shiraki, Takayuki; Sakuraoka, Yuki; Iso, Yukihiro; Kato, Masato; Kubota, Keiichi
• Is Part Of: ANZ journal of surgery. Volume 89:Issue 9(2019)
• Page Start: E363
• Page End: E367
• Publication Date: 2019-07-07
• Subjects: distal cholangiocarcinoma -- endoscopic biliary drainage -- pancreatoduodenectomy -- percutaneous transhepatic biliary drainage -- preoperative biliary drainage; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.15329
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Background: The aim of this study was to investigate the long‐term impact of the type of preoperative biliary drainage used for patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma (DCC). Methods: A total of 84 patients with DCC who underwent preoperative biliary drainage between June 2000 and December 2016 were divided into groups for whom percutaneous transhepatic biliary drainage (PTBD) ( n = 24) or endoscopic biliary drainage (EBD) ( n = 60) was used. Results: The 5‐year overall survival in the PTBD group was significantly worse than that in the EBD group (16.7% versus 52.3%, P = 0.007). After propensity score matching (22 patients in each group), the 5‐year overall survival in the PTBD group was still worse than that in the EBD group (13.6% versus 61.2%, P = 0.003). Multivariate analysis revealed that PTBD was independent risk factor for both poor survival ( P = 0.028) and peritoneal recurrence ( P = 0.018). The incidence of multiple sites at initial recurrence tended to be higher in the PTBD group than in the EBD group ( P = 0.080). Conclusions: PTBD should not be performed for patients undergoing pancreatoduodenectomy for DCC, except when EBD is contraindicated, as PTBD is significantly associated with shorter survival and peritoneal recurrence.