Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study
Abstract Objectives Perihilar cholangiocarcinoma (PCC) is a complex disorder involving the hepatic hilum. Multiple endoscopic retrograde cholangiopancreatography sessions are necessary for diagnosis and treatment with underlying cholangitis risk. Our aim is to clarify the initial‐drainage‐related pr...
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Wiley
2023-04-01
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| Online Access: | https://doi.org/10.1002/deo2.127 |
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| author | Katsuhiko Sato Minoru Shigekawa Kazuhiro Kozumi Junya Okabe Yu Sato Takeshi Tamura Teppei Yoshioka Ryotaro Sakamori Yoshifumi Iwagami Daisaku Yamada Yoshito Tomimaru Takehiro Noda Hidenori Takahashi Shogo Kobayashi Hidetoshi Eguchi Tomohide Tatsumi Tetsuo Takehara |
| author_facet | Katsuhiko Sato Minoru Shigekawa Kazuhiro Kozumi Junya Okabe Yu Sato Takeshi Tamura Teppei Yoshioka Ryotaro Sakamori Yoshifumi Iwagami Daisaku Yamada Yoshito Tomimaru Takehiro Noda Hidenori Takahashi Shogo Kobayashi Hidetoshi Eguchi Tomohide Tatsumi Tetsuo Takehara |
| author_sort | Katsuhiko Sato |
| collection | DOAJ |
| description | Abstract Objectives Perihilar cholangiocarcinoma (PCC) is a complex disorder involving the hepatic hilum. Multiple endoscopic retrograde cholangiopancreatography sessions are necessary for diagnosis and treatment with underlying cholangitis risk. Our aim is to clarify the initial‐drainage‐related prognostic factors of PCC. Methods This study was a single‐center retrospective study. A total of 104 consecutive patients diagnosed with PCC from January 2010 to February 2020 were enrolled. We defined the diagnostic period as the time between the first biliary drainage attempt and the final drainage when treatment, including surgery or chemotherapy, was started. We focused on this initial period and analyzed the endoscopy‐related factors that affected mortality. Results Overall survival of all PCC patients was 599 days. Overall survival of surgically treated patients and unresectable patients were 893 days and 512 days, respectively. In 48 surgically treated patients, drainage‐related cholangitis within the diagnostic period, defined as new cholangitis that occurred after the first biliary drainage attempt, worsened overall survival from 1460 days to 607 days. Endoscopic sphincterotomy, the first drainage method other than endoscopic nasobiliary drainage, and four or more endoscopic retrograde cholangiopancreatography sessions were risk factors for drainage‐related cholangitis. Drainage‐related cholangitis increased pathological lymph node metastasis. Percutaneous transhepatic biliary drainage as final drainage was the only prognostic factor in unresectable chemotherapy‐treated patients. Conclusions Drainage‐related cholangitis worsened the prognosis in PCC patients who underwent surgery. Appropriate endoscopic retrograde cholangiopancreatography strategies, especially during the diagnostic period, are of great importance in PCC. |
| format | Article |
| id | doaj-art-5af7df7195fc46638fbb71370fd507a2 |
| institution | OA Journals |
| issn | 2692-4609 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj-art-5af7df7195fc46638fbb71370fd507a22025-08-20T01:50:18ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.127Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective studyKatsuhiko Sato0Minoru Shigekawa1Kazuhiro Kozumi2Junya Okabe3Yu Sato4Takeshi Tamura5Teppei Yoshioka6Ryotaro Sakamori7Yoshifumi Iwagami8Daisaku Yamada9Yoshito Tomimaru10Takehiro Noda11Hidenori Takahashi12Shogo Kobayashi13Hidetoshi Eguchi14Tomohide Tatsumi15Tetsuo Takehara16Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterological Surgery Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanDepartment of Gastroenterology and Hepatology Osaka University Graduate School of Medicine Osaka JapanAbstract Objectives Perihilar cholangiocarcinoma (PCC) is a complex disorder involving the hepatic hilum. Multiple endoscopic retrograde cholangiopancreatography sessions are necessary for diagnosis and treatment with underlying cholangitis risk. Our aim is to clarify the initial‐drainage‐related prognostic factors of PCC. Methods This study was a single‐center retrospective study. A total of 104 consecutive patients diagnosed with PCC from January 2010 to February 2020 were enrolled. We defined the diagnostic period as the time between the first biliary drainage attempt and the final drainage when treatment, including surgery or chemotherapy, was started. We focused on this initial period and analyzed the endoscopy‐related factors that affected mortality. Results Overall survival of all PCC patients was 599 days. Overall survival of surgically treated patients and unresectable patients were 893 days and 512 days, respectively. In 48 surgically treated patients, drainage‐related cholangitis within the diagnostic period, defined as new cholangitis that occurred after the first biliary drainage attempt, worsened overall survival from 1460 days to 607 days. Endoscopic sphincterotomy, the first drainage method other than endoscopic nasobiliary drainage, and four or more endoscopic retrograde cholangiopancreatography sessions were risk factors for drainage‐related cholangitis. Drainage‐related cholangitis increased pathological lymph node metastasis. Percutaneous transhepatic biliary drainage as final drainage was the only prognostic factor in unresectable chemotherapy‐treated patients. Conclusions Drainage‐related cholangitis worsened the prognosis in PCC patients who underwent surgery. Appropriate endoscopic retrograde cholangiopancreatography strategies, especially during the diagnostic period, are of great importance in PCC.https://doi.org/10.1002/deo2.127cholangiocarcinomacholangitisdrainageendoscopic retrograde cholangiopancreatographyendoscopic sphincterotomy |
| spellingShingle | Katsuhiko Sato Minoru Shigekawa Kazuhiro Kozumi Junya Okabe Yu Sato Takeshi Tamura Teppei Yoshioka Ryotaro Sakamori Yoshifumi Iwagami Daisaku Yamada Yoshito Tomimaru Takehiro Noda Hidenori Takahashi Shogo Kobayashi Hidetoshi Eguchi Tomohide Tatsumi Tetsuo Takehara Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study DEN Open cholangiocarcinoma cholangitis drainage endoscopic retrograde cholangiopancreatography endoscopic sphincterotomy |
| title | Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study |
| title_full | Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study |
| title_fullStr | Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study |
| title_full_unstemmed | Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study |
| title_short | Initial drainage‐related prognostic factors for perihilar cholangiocarcinoma: A single‐center retrospective study |
| title_sort | initial drainage related prognostic factors for perihilar cholangiocarcinoma a single center retrospective study |
| topic | cholangiocarcinoma cholangitis drainage endoscopic retrograde cholangiopancreatography endoscopic sphincterotomy |
| url | https://doi.org/10.1002/deo2.127 |
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