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01-02-2012

Reappraisal of Percutaneous Transhepatic Biliary Drainage Tract Recurrence After Resection of Perihilar Bile Duct Cancer

Authors: Shin Hwang, Gi-Won Song, Tae-Yong Ha, Young-Joo Lee, Ki-Hun Kim, Chul-Soo Ahn, Kyu-Bo Sung, Gi-Young Ko, Myeong-Hwan Kim, Sung-Koo Lee, Deok-Bog Moon, Dong-Hwang Jung, Gil-Chun Park, Sung-Gyu Lee

Published in: World Journal of Surgery | Issue 2/2012

Abstract

Background

The high incidence of percutaneous transhepatic biliary drainage (PTBD) tract recurrence after resection of perihilar bile duct cancer (BDC) at a reference single center has suggested the need for endoscopic biliary drainage (EBD) to prevent PTBD-related tumor recurrence. To determine the general applicability of these findings, we validated the risk of PTBD tract recurrence in patients with resected BDC in our high-volume center.

Methods

The medical records of 306 patients with perihilar BDC who underwent hepatobiliary resection with curative intent over 10 years were reviewed retrospectively.

Results

Of the 306 patients, 293 (95.8%) underwent biliary decompression, 171 (56.1%) by preoperative PTBD, 62 (20.3%) by EBD alone, and 60 (19.7%) by both. Of the 231 patients who underwent PTBD, 160 (69.3%), 62 (26.8%), and 9 (3.9%) had one, two, or three catheters, respectively (mean of 1.3 catheters per patient for a median 23 days). No patient experienced synchronous PTBD tract metastasis, whereas 4 (1.7%) experienced PTBD tract recurrence a median 13.5 months after surgery, with 3 of these patients having an intraabdominal recurrence soon afterward. Only one patient had a solitary tract recurrence without intraabdominal metastasis. These patients survived for a median 25 months, which is comparable to survival outcomes after noncurative resection. No risk factor was significantly associated with PTBD tract recurrence.

Conclusions

We think that the risk of PTBD tract recurrence after resection of perihilar BDC is not negligible but is much lower than previously reported. There is no definitive reason to avoid PTBD when it is indicated.

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Title: Reappraisal of Percutaneous Transhepatic Biliary Drainage Tract Recurrence After Resection of Perihilar Bile Duct Cancer
Authors: Shin Hwang
Gi-Won Song
Tae-Yong Ha
Young-Joo Lee
Ki-Hun Kim
Chul-Soo Ahn
Kyu-Bo Sung
Gi-Young Ko
Myeong-Hwan Kim
Sung-Koo Lee
Deok-Bog Moon
Dong-Hwang Jung
Gil-Chun Park
Sung-Gyu Lee
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1364-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reappraisal of Percutaneous Transhepatic Biliary Drainage Tract Recurrence After Resection of Perihilar Bile Duct Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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