| セッション情報 | International Session6(消化器内視鏡学会・消化器病学会合同)Strategy of biliary drainage for hilar biliary strictures |
|---|---|
| タイトル | 内IS6-2：Preoperative biliary drainage for malignant hilar biliary stricture caused by gallbladder carcinoma or intrahepatic cholangiocarcinoma |
| 演者 | M. Kuwatani（Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine） |
| 共同演者 | H. Kawakami（Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine）, N. Sakamoto（Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine） |
| 抄録 | <Background> It is controversial which preoperative biliary drainage (PBD) is the most suitable for malignant hilar biliary stricture (MHBS) caused by gallbladder carcinoma (GBC) or intrahepatic cholangiocarcinoma (ICC), endoscopic nasobiliary drainage (ENBD), percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary stenting (EBS). <Aim> To clarify the most suitable preoperative drainage method for patients with MHBS caused by GBC or ICC. <Patients and Methods> Between 2000 and 2012, we enrolled 58 patients with MHBS caused by GBC or ICC who underwent preoperative ENBD, PTBD or EBS. The patients were divided into ENBD (n=35), EBS (n=8) and PTBD (n=15) groups according to the first drainage method. We retrospectively investigated patient characteristics and efficacy and complications caused by drainage. <Results> The patients included 33 males and 25 females with an average age of 67.7 yrs. Forty-six patients had GBC and 12 patients had ICC. There were no significant differences in preoperative laboratory data, decompression periods (21.2, 28.6, 33.4 days) and periods from the first drainage to surgery (58.9, 82.1, 72.9 days) among the 3 groups. Complications occurred in 14% (5/35, dislocation, 3; obstruction, 2), 75% (6/8, obstruction, 4; dislocation, 1; pancreatitis, 1), and 27% (4/15, dislocation, 2; cancer dissemination, 1; portal vein injury, 1) in the ENBD, EBS, and PTBD groups, respectively (P=0.008). <Conclusion> ENBD is the most suitable PBD for MHBS caused by GBC or ICC. |
| 索引用語 | ENBD, hilar biliary stricture |