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

Autor:	Latenstein AEJ; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: a.e.latenstein@amsterdamumc.nl., Mackay TM; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., van Huijgevoort NCM; Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Bonsing BA; Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands., Bosscha K; Department of Surgery, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands., Hol L; Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, the Netherlands., Bruno MJ; Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands., van Coolsen MME; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands., Festen S; Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., van Geenen E; Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands., Groot Koerkamp B; Department of Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands., Hemmink GJM; Department of Gastroenterology and Hepatology, Isala, Zwolle, the Netherlands., de Hingh IHJT; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Kazemier G; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands., Lubbinge H; Department of Gastroenterology and Hepatology, Tjongerschans, Heerenveen, the Netherlands., de Meijer VE; Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Molenaar IQ; Department of Surgery, Regional Academic Cancer Center Utrecht, St Antonius Hospital Nieuwegein, Utrecht, the Netherlands., Quispel R; Department of Gastroenterology and Hepatology, Reinier de Graaf Ziekenhuis, Delft, the Netherlands., van Santvoort HC; Department of Surgery, Regional Academic Cancer Center Utrecht, St Antonius Hospital Nieuwegein, Utrecht, the Netherlands., Seerden TCJ; Department of Gastroenterology and Hepatology, Amphia Hospital, Breda, the Netherlands., Stommel MWJ; Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands., Venneman NG; Department Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, the Netherlands., Verdonk RC; Department of Gastroenterology and Hepatology, Regional Academic Cancer Center Utrecht, St Antonius Hospital Nieuwegein, Utrecht, the Netherlands., Besselink MG; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., van Hooft JE; Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: j.e.vanhooft@amsterdamumc.nl.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2021 Feb; Vol. 23 (2), pp. 270-278. Date of Electronic Publication: 2020 Jul 16.
DOI:	10.1016/j.hpb.2020.06.009
Abstrakt:	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). Multivariable 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. (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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