Retrospective cohort study Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma

作     者：Kazumichi Kawakubo Hiroshi Kawakami Masaki Kuwatani Shin Haba Taiki Kudo Yoko A Taya Shuhei Kawahata Yoshimasa Kubota Kimitoshi Kubo Kazunori Eto Nobuyuki Ehira Hiroaki Yamato Manabu Onodera Naoya Sakamoto 

作者机构：Department of Gastroenterology and Hepatology Hokkaido University Graduate School of Medicine Sapporo 0608638Japan 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2016年第8卷第9期

页      面：385-390页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Hilar cholangiocarcinoma Endoscopic nasobiliary drainage Endoscopic biliary stenting Endoscopic sphincterotomy Complications 

摘      要：AIM:To identify the most effective endoscopic biliary drainage technique for patients with hilar ***:In total,118 patients with hilar cholangiocarcinoma underwent endoscopic management[endoscopic nasobiliary drainage(ENBD)or endoscopic biliary stenting]as a temporary drainage in our institution between 2009 and *** retrospectively evaluated all complications from initial endoscopic drainage to surgery or palliative *** risk factors for biliary reintervention,post-endoscopic retrograde cholangiopancreatography(post-ERCP)pancreatitis,and percutaneous transhepatic biliary drainage(PTBD)were also analyzed using patient-and procedure-related *** risk factors for bilateral drainage were examined in a subgroup analysis of patients who underwent initial unilateral ***:In total,137 complications were observed in92(78%)*** reintervention was required in 83(70%)*** was significantly associated with a low risk of biliary reintervention[odds ratio(OR)=0.26,95%CI:0.08-0.76,P=0.012].Post-ERCP pancreatitis was observed in 19(16%)*** absence of endoscopic sphincterotomy was significantly associated with post-ERCP pancreatitis(OR=3.46,95%CI:1.19-10.87,P=0.023).PTBD was required in 16(14%)patients,and Bismuth type III or IV cholangiocarcinoma was a significant risk factor(OR=7.88,95%CI:1.33-155.0,P=0.010).Of 102 patients with initial unilateral drainage,49(48%)required bilateral *** sphincterotomy(OR=3.24,95%CI:1.27-8.78,P=0.004)and Bismuth II,III,or IV cholangiocarcinoma(OR=34.69,95%CI:4.88-736.7,P0.001)were significant risk factors for bilateral ***:The endoscopic management of hilar cholangiocarcinoma is *** should be selected as a temporary drainage method because of its low risk of complications.