Oncologic effects of preoperative biliary drainage in resectable hilar cholangiocarcinoma: Percutaneous biliary drainage has no adverse effects on survival

Xu Feng Zhang, Eliza W. Beal, Katiuscha Merath, Cecilia G. Ethun, Ahmed Salem, Sharon M. Weber, Thuy Tran, George Poultsides, Andre Y. Son, Ioannis Hatzaras, Linda Jin, Ryan C. Fields, Matthew Weiss, Charles Scoggins, Robert C.G. Martin, Chelsea A. Isom, Kamron Idrees, Harveshp D. Mogal, Perry Shen, Shishir K. MaithelCarl R. Schmidt, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objectives: The objective of the current study was to define long-term survival of patients with resectable hilar cholangiocarcinoma (HCCA) after preoperative percutaneous transhepatic biliary drainage (PTBD) versus endoscopic biliary drainage (EBD). Methods: Between 2000 and 2014, 240 patients who underwent curative-intent resection for HCCA were identified at 10 major hepatobiliary centers. Postoperative morbidity and mortality, as well as disease-specific survival (DSS) and recurrence-free survival (RFS) were analyzed among patients. Results: The median decrease in total bilirubin levels after biliary drainage was similar comparing PTBD (n = 104) versus EBD (n = 92) (mg/dL, 4.9 vs 4.9, P = 0.589) before surgery. There was no difference in baseline demographic characteristics, type of surgical procedure performed, final AJCC tumor stage or postoperative morbidity among patients who underwent EBD only versus PTBD (all P > 0.05). Patients who underwent PTBD versus EBD had a comparable long-term DSS (median, 43.7 vs 36.9 months, P = 0.802) and RFS (median, 26.7 vs 24.0 months, P = 0.571). The overall pattern of recurrence relative to regional or distant disease was also the same among patients undergoing PTBD and EBD (P = 0.669). Conclusions: Oncologic outcomes including DSS and RFS were similar among patients who underwent PTBD versus EBD with no difference in tumor recurrence location.

Original languageEnglish (US)
Pages (from-to)1267-1277
Number of pages11
JournalJournal of Surgical Oncology
Volume117
Issue number6
DOIs
StatePublished - May 1 2018

Keywords

  • biliary drainage
  • endoscopic biliary drainage
  • hilar cholangiocarcinoma
  • outcomes
  • percutaneous transhepatic biliary drainage

ASJC Scopus subject areas

  • Surgery
  • Oncology

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