Endoscopy international open · 2018
Effectiveness of a modified 6-Fr endoscopic nasobiliary drainage catheter for patients with preoperative perihilar cholangiocarcinoma.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Kawashima Hiroki, Hirooka Yoshiki, Ohno Eizaburo, Ishikawa Takuya, Miyahara Ryoji, Watanabe Osamu, Hayashi Kazuhiko, Ishigami Masatoshi, Hashimoto Senju, Ebata Tomoki, Nagino Masato, Goto Hidemi
Аннотация
BACKGROUND AND STUDY AIMS: To decrease complications associated with preoperative endoscopic nasobiliary drainage (ENBD) for perihilar cholangiocarcinoma patients, we developed a modified 6-Fr ENBD catheter with multiple side holes (m-ENBD). The aim of this retrospective study was to compare the m-ENBD catheter with a conventional 7-Fr ENBD catheter (c-ENBD).
PATIENTS AND METHODS: This study involved 371 patients with suspected perihilar cholangiocarcinoma who underwent ENBD using a c-ENBD catheter or an m-ENBD catheter. The effectiveness of each catheter and the incidence of complications were evaluated. Univariate and multivariate analyses followed by propensity score matching were performed.
RESULTS: In 145 patients with total bilirubin levels ≥ 2.0 mg/dL prior to drainage, these levels decreased to < 2.0 mg/dL after ENBD in 81.1 % of the c-ENBD patients and in 74.0 % of the m-ENBD patients ( P = 0.325). Post-ENBD cholangitis occurred in 24.9 % of the c-ENBD patients and in 12.4 % of the m-ENBD patients ( P = 0.006). After propensity score matching, the rate of post-ENBD cholangitis ( P = 0.007) and the number of patients requiring subsequent or additional drainage ( P = 0.030) were significantly lower in the m-ENBD group.
CONCLUSION: The modified 6-Fr ENBD catheter was associated with a lower incidence of post-ENBD cholangitis than the conventional 7-Fr ENBD catheter, and the incidence of subsequent or additional drainage procedures was also decreased.
PATIENTS AND METHODS: This study involved 371 patients with suspected perihilar cholangiocarcinoma who underwent ENBD using a c-ENBD catheter or an m-ENBD catheter. The effectiveness of each catheter and the incidence of complications were evaluated. Univariate and multivariate analyses followed by propensity score matching were performed.
RESULTS: In 145 patients with total bilirubin levels ≥ 2.0 mg/dL prior to drainage, these levels decreased to < 2.0 mg/dL after ENBD in 81.1 % of the c-ENBD patients and in 74.0 % of the m-ENBD patients ( P = 0.325). Post-ENBD cholangitis occurred in 24.9 % of the c-ENBD patients and in 12.4 % of the m-ENBD patients ( P = 0.006). After propensity score matching, the rate of post-ENBD cholangitis ( P = 0.007) and the number of patients requiring subsequent or additional drainage ( P = 0.030) were significantly lower in the m-ENBD group.
CONCLUSION: The modified 6-Fr ENBD catheter was associated with a lower incidence of post-ENBD cholangitis than the conventional 7-Fr ENBD catheter, and the incidence of subsequent or additional drainage procedures was also decreased.