| 抄録 |
(Background) The optimal approach for preoperative drainage for hilar cholangiocarcinoma (HA) is still controversial. (Purpose) The aim of this study was to examine whether preoperative percutaneous transhepatic biliary drainage (PTBD) or endoscopic nasobiliary drainage (ENBD) is better for HA, especially with regard to oncological outcomes. (Methods) Between 2000 and 2011, 124 consecutive patients underwent surgery for HA. We retrospectively examined outcomes and recurrence in 118 patients who tolerated surgery. Subjects were divided into the PTBD (63 patients), ENBD (41 patients), and no drainage (ND; 14 patients) groups. (Result) The 5-year overall survival rates in the PTBD, ENBD, and ND groups were 37.1%, 58.3%, and 62.5%, respectively, and the difference was not significant. The 5-year survival rates among R0M0 patients in the PTBD, ENBD, and ND groups were 46.8%, 64.4%, and 66.7%, respectively; this difference was not significant either. Further, the rates of liver, lymph node, and local recurrence did not differ between the groups. However, the rate of dissemination or fistula recurrence was significantly higher in the PTBD group (26.7%) than in the ENBD group (12.9%, P = 0.044). (Conclusion) With regard to oncological outcomes, the possibility of increased dissemination and fistula recurrence was higher with PTBD than with ENBD. |
