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Preoperative biliary drainage for hilar cholangiocarcinoma: which stent should be selected?
Author(s) -
Kawakami Hiroshi,
Kondo Satoshi,
Kuwatani Masaki,
Yamato Hiroaki,
Ehira Nobuyuki,
Kudo Taiki,
Eto Kazunori,
Haba Shin,
Matsumoto Joe,
Kato Kentaro,
Tsuchikawa Takahiro,
Tanaka Eiichi,
Hirano Satoshi,
Asaka Masahiro
Publication year - 2011
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-011-0404-7
Subject(s) - medicine , biliary drainage , jaundice , stent , percutaneous , biliary stent , endoscopic stenting , surgery , drainage , liver function , obstructive jaundice , complication , general surgery , gastroenterology , ecology , biology
The controversy over whether and how to perform preoperative biliary drainage (PBD) in patients with hilar cholangiocarcinoma (HCA) remains unsettled. Arguments against PBD before pancreatoduodenectomy have recently been gaining momentum. However, the complication‐related mortality rate is as high as 10% for patients with HCA who have undergone major liver resection, and liver failure is a major cause of postoperative death. This suggests the need for PBD to treat jaundice in HCA patients scheduled for major surgical resection of the liver and that major surgery should be performed only after the recovery of hepatic function. No definite criteria or guidelines outlining indications for PBD are currently available. In patients with HCA, PBD may be performed by either percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary drainage (EBD). No consensus, however, has been reached regarding which drainage method is more appropriate. No reported study has compared the effectiveness of PTBD, endoscopic biliary stenting (EBS), and endoscopic nasobiliary drainage (ENBD) in patients with HCA. This review summarizes the results of our study comparing the three methods and outlines the preoperative endoscopic management of segmental cholangitis (SC) in HCA patients undergoing PBD.