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Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma:When and how?

World Journal of Gastrointestinal Oncology 2021年第12期13卷 2050-2063页

作者： Tudor Mocan Adelina Horhat Emil Mois Florin Graur Cristian Tefas Rares Craciun Iuliana Nenu Mihaela Spârchez Zeno Sparchez Third Medical Department "Iuliu Hatieganu"University of Medicine and PharmacyCluj-Napoca 400162Romania Institute for Gastroenterology and Hepatology Cluj-Napoca 400162Romania Second Pediatric Department University of Medicine and Pharmacy"Iuliu Hatieganu"Cluj-Napoca 400162Romania

Hilar cholangiocarcinoma (hCCA) is a primary liver tumor associated with a dimprognosis. The role of preoperative and palliative biliary drainage has long beendebated. The most common techniques are endoscopic retrograde cholangiopancreatography(ERCP) and percutaneous transhepatic biliary drainage (PTBD);however, recently developed endoscopic ultrasound-assisted methods are gainingmore atention. Selecting the best available method in any specific scenario iscrucial, yet sometimes challenging. Thus, this review aimed to discuss theavailable techniques, indications, perks, pitfalls, and timing-related issues in themanagement of hCCA. In a preoperative setting, PTBD appears to have someadvantages: low risk of postprocedural complications (namely cholangitis) andbetter priming for surgery. For palliative purposes, we propose ERCP/PTBDdepending on the experience of the operators, but also on other factors: the levelof bilirubin (if very high, rather PTBD), length of the stenosis and the presence ofcholangitis (PTBD), ERCP failure, or altered biliary anatomy.

关键词： Hilar cholangiocarcinoma Endoscopic biliary drainage percutaneous biliary drainage Endoscopic ultrasound biliary drainage Surgical oncology

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Factors relating to the short term effectiveness of percutaneous biliary drainage for hilar cholangiocarcinoma

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World Journal of Gastroenterology 2009年第41期15卷 5206-5210页

作者： Hong-Ming Tsai Chiao-Hsiung Chuang Xi-Zhang Lin Chiung-Yu Chen Departments of Radiology College of Medicine National Cheng Kung University Tainan 704 Taiwan China Departments of Internal Medicine College of Medicine National Cheng Kung University Tainan 704 Taiwan China

AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. METHODS: Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after ***: Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not signif icantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). CONCLUSION: The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.

关键词： Cholangiocarcinoma percutaneous biliary drainage Treatment effectiveness

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Overview of endoscopic biliary stenting in malignant obstructive jaundice

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World Journal of Gastrointestinal Surgery 2025年第2期17卷 20-24页

作者： Hui Wang Yan Jiao Qiang Ma Ya-Hui Liu First Operation Room The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Hepatobiliary and Pancreatic Surgery General Surgery CenterThe First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina Department of Emergency Surgery The First Hospital of Jilin UniversityChangchun 130021Jilin ProvinceChina

This article discusses Wang et al’s *** biliary stenting,a less invasive alternative to surgery,is effective for malignant obstructive *** article summarizes the pathophysiology of biliary obstruction,the technical aspects of stenting,and the clinical *** comparison of endoscopic stenting with percutaneous biliary drainage,improvements and complications are focused ***,patient selection for stenting and future advancements in stent technology are ***,endoscopic biliary stenting is a valuable palliative option for patients with malignant jaundice,especially those ineligibles for surgery.

关键词： Endoscopic biliary stenting Malignant Obstructive jaundice Surgery percutaneous biliary drainage

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