Abstract
Background
Extensive controversies exist over the use of preoperative biliary drainage preceding
radical resection of hilar cholangiocarcinoma. This study assessed the effectiveness
and safety of percutaneous transhepatic cholangiodrainage (PTCD) with bile re-infusion
in the preoperative optimization of hilar cholangiocarcinoma patients.
Methods
Eligible hilar cholangiocarcinoma patients received preoperative PTCD with bile re-infusion
(treatment group, n=56) through a nasoduodenal tube for 2 weeks, and the control group (n=60) received conservative treatment alone. Operable patients were assigned to undergo
either a radical or palliative resection. The outcome measures included the overall
resection rate, R0 resection rate, surgical morbidity rate and 1-year and 5-year overall
survival rates.
Results
The treatment group exhibited a significant decrease in serum bilirubin levels after
PTCD with bile re-infusion. The overall resection rate was significantly higher in
the treatment group than in the control group (85.5% vs. 65.0%, P<0.05), and the palliative resection rate was also significantly higher in the treatment
group (53.5% vs. 35.0%, P<0.05). However, the R0 resection rate was comparable between the 2 groups (32.1% vs.
30.0%, P>0.05). The morbidity rate was significantly lower in the treatment group than in the
control group (29.1% vs. 51.3%, P<0.05). One-year and 5-year survival rates were similar between the 2 groups (69.6%
vs. 66.7%, P>0.05; 5.3% vs. 3.6%, P > 0.05).
Conclusions
Preoperative PTCD with bile re-infusion improves the resection rate and shows a good
safety profile in patients with hilar cholangiocarcinoma.
Key Indexing Terms
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Article info
Publication history
Accepted:
September 20,
2012
Received:
June 22,
2012
Footnotes
Supported in part by a grant from Zhejiang Provincial Top Key Discipline in Surgery.
The authors declare no conflict of interest.
Identification
Copyright
© 2012 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
