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Langenbeck's Archives of Surgery

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Cholangitis prevention in endoscopic Klatskin tumor palliation: air cholangiography technique

Authors: Franco Pisello, Girolamo Geraci, Giuseppe Modica, Carmelo Sciumè

Published in: Langenbeck's Archives of Surgery | Issue 6/2009

Abstract

Introduction

Endoscopic biliary drainage is the treatment of choice for inoperable hilar cholangiocarcinoma (so-called Klatskin tumor). Cholangitis is the main complication post-endoscopic retrograde cholangiopancreatography (ERCP) in Klatskin patients, specially when medium contrast is injected into biliary tree that could not be subsequently drained. Bacterial cholangitis is the principal cause of mortality in these patients. The aim of this study is to analyze cholangitis rate resulting from the use of air versus iodine contrast to obtain cholangiography during ERCP.

Methods

In 9 years, 188 inoperable Klatskin patients were recruited and divided into two groups: iodine (A) or air (B) contrast cholangiography, respectively. We used air or iodine contrast to obtain cholangiography before hilar stricture stenting. We retrospectively compared these data in both groups.

Results

The group B had a significant lower rate of cholangitis than group A in Bismuth type II (p < 0.05), in Bismuth type III (p < 0.05), and in the Bismuth type IV population (p < 0.05).

Conclusion

The air contrast cholangiography is a safe and effective method, and it appears justified as a routine procedure to prevent or reduce the risk of post-ERCP cholangitis, specially in Klatskin patients (p < 0.005).

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Title: Cholangitis prevention in endoscopic Klatskin tumor palliation: air cholangiography technique
Authors: Franco Pisello
Girolamo Geraci
Giuseppe Modica
Carmelo Sciumè
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 6/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-009-0548-y

At a glance: The STEP trials

Springer Medicine

Cholangitis prevention in endoscopic Klatskin tumor palliation: air cholangiography technique

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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