Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

被引：9

作者：

Latenstein, Anouk E. J. ^{[1
]}

Mackay, Tara M. ^{[1
]}

van Huijgevoort, Nadine C. M. ^{[2
]}

Bonsing, Bert A. ^{[3
]}

Bosscha, Koop ^{[4
]}

Hol, Lieke ^{[5
]}

Bruno, Marco J. ^{[6
]}

van Coolsen, Marielle M. E. ^{[7
]}

Festen, Sebastiaan ^{[8
]}

van Geenen, Erwin ^{[9
]}

Koerkamp, Bas Groot ^{[10
]}

Hemmink, Gerrit J. M. ^{[11
]}

de Hingh, Ignace H. J. T. ^{[12
]}

Kazemier, Geert ^{[13
]}

Lubbinge, Hans ^{[14
]}

de Meijer, Vincent E. ^{[15
]}

Molenaar, I. Quintus ^{[16
]}

Quispel, Rutger ^{[17
]}

van Santvoort, Hjalmar C. ^{[16
]}

Seerden, Tom C. J. ^{[18
]}

Stommel, Martijn W. J. ^{[19
]}

Venneman, Niels G. ^{[20
]}

Verdonk, Robert C. ^{[21
]}

Besselink, Marc G. ^{[1
]}

van Hooft, Jeanin E. ^{[2
]}

机构：

[1] Univ Amsterdam, Canc Ctr Amsterdam, Amsterdam UMC, Dept Surg, Amsterdam, Netherlands

[2] Univ Amsterdam, Canc Ctr Amsterdam, Amsterdam UMC, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands

[3] Leiden Univ, Dept Surg, Med Ctr, Leiden, Netherlands

[4] Jeroen Bosch Hosp, Dept Surg, Shertogenbosch, Netherlands

[5] Maasstad Hosp, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[6] Erasmus MC Univ Med Ctr, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[7] Maastricht Univ Med Ctr, Dept Surg, Maastricht, Netherlands

[8] Onze Lieve Vrouw Hosp, Dept Surg, Amsterdam, Netherlands

[9] Radboud Univ Nijmegen Med Ctr, Dept Gastroenterol & Hepatol, Nijmegen, Netherlands

[10] Erasmus MC Univ Med Ctr, Dept Surg, Rotterdam, Netherlands

[11] Isala, Dept Gastroenterol & Hepatol, Zwolle, Netherlands

[12] Catharina Hosp, Dept Surg, Eindhoven, Netherlands

[13] Vrije Univ Amsterdam, Canc Ctr Amsterdam, Dept Surg, Amsterdam UMC, Amsterdam, Netherlands

[14] Tjongerschans, Dept Gastroenterol & Hepatol, Heerenveen, Netherlands

[15] Univ Groningen, Univ Med Ctr Groningen, Dept Hepatobiliary Surg & Liver Transplantat, Groningen, Netherlands

[16] St Antonius Hosp Nieuwegein, Reg Acad Canc Ctr Utrecht, Dept Surg, Utrecht, Netherlands

[17] Reinier de Graaf Ziekenhuis, Dept Gastroenterol & Hepatol, Delft, Netherlands

[18] Amphia Hosp, Dept Gastroenterol & Hepatol, Breda, Netherlands

[19] Radboud Univ Nijmegen Med Ctr, Dept Surg, Nijmegen, Netherlands

[20] Med Spectrum Twente, Dept Gastroenterol & Hepatol, Enschede, Netherlands

[21] St Antonius Hosp Nieuwegein, Reg Acad Canc Ctr Utrecht, Dept Gastroenterol & Hepatol, Utrecht, Netherlands

来源：

HPB | 2021年 / 23卷 / 02期

关键词：

INTERNATIONAL STUDY-GROUP; EXPANDING METAL STENTS; PLASTIC STENTS; NEOADJUVANT THERAPY; GUIDELINES; EFFICACY; SURGERY; CLASSIFICATION; OBSTRUCTION; DEFINITION;

D O I：

10.1016/j.hpb.2020.06.009

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes. Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Multi variable logistic and linear regression models were performed. Results: In total, 575/1056 patients (62.0%) underwent preoperative EBD: 246 SEMS (42.8%) and 329 plastic stents (57.2%). EBD-related complications were comparable between the groups (44/246 (17.9%) vs. 64/329 (19.5%), p = 0.607), including pancreatitis (22/246 (8.9%) vs. 25/329 (7.6%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1%) vs. 32/329 (9.7%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6%) vs. 90/329 (27.4%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8%) vs. 61/329 (18.5%), p = 0.004; OR 0.50 95%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95%CI -5.16 to -0.57, p = 0.014) were less after SEMS placement. Conclusion: This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.

引用

页码：270 / 278

页数：9

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