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

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World Journal of Gastrointestinal Endoscopy 2016年第9期8卷 385-390页

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 Department of Gastroenterology and Hepatology Hokkaido University Graduate School of Medicine Sapporo 0608638Japan

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,P<0.001)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.

关键词： Hilar cholangiocarcinoma Endoscopic nasobiliary drainage Endoscopic biliary stenting Endoscopic sphincterotomy Complications

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