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Oncologic effects of preoperative biliary drainage in resectable hilar cholangiocarcinoma: Percutaneous biliary drainage has no adverse effects on survival
Author(s) -
Zhang XuFeng,
Beal Eliza W.,
Merath Katiuscha,
Ethun Cecilia G.,
Salem Ahmed,
Weber Sharon M.,
Tran Thuy,
Poultsides George,
Son Andre Y.,
Hatzaras Ioannis,
Jin Linda,
Fields Ryan C.,
Weiss Matthew,
Scoggins Charles,
Martin Robert C.G.,
Isom Chelsea A.,
Idrees Kamron,
Mogal Harveshp D.,
Shen Perry,
Maithel Shishir K.,
Schmidt Carl R.,
Pawlik Timothy M.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24945
Subject(s) - medicine , biliary drainage , percutaneous , surgery , adverse effect , stage (stratigraphy) , overall survival , bilirubin , gastroenterology , paleontology , biology
Background and Objectives The objective of the current study was to define long‐term survival of patients with resectable hilar cholangiocarcinoma (HCCA) after preoperative percutaneous transhepatic biliary drainage (PTBD) versus endoscopic biliary drainage (EBD). Methods Between 2000 and 2014, 240 patients who underwent curative‐intent resection for HCCA were identified at 10 major hepatobiliary centers. Postoperative morbidity and mortality, as well as disease‐specific survival (DSS) and recurrence‐free survival (RFS) were analyzed among patients. Results The median decrease in total bilirubin levels after biliary drainage was similar comparing PTBD ( n = 104) versus EBD ( n = 92) (mg/dL, 4.9 vs 4.9, P = 0.589) before surgery. There was no difference in baseline demographic characteristics, type of surgical procedure performed, final AJCC tumor stage or postoperative morbidity among patients who underwent EBD only versus PTBD (all P > 0.05). Patients who underwent PTBD versus EBD had a comparable long‐term DSS (median, 43.7 vs 36.9 months, P = 0.802) and RFS (median, 26.7 vs 24.0 months, P = 0.571). The overall pattern of recurrence relative to regional or distant disease was also the same among patients undergoing PTBD and EBD ( P = 0.669) Conclusions Oncologic outcomes including DSS and RFS were similar among patients who underwent PTBD versus EBD with no difference in tumor recurrence location.