The strategy for the preoperative biliary drainage of hilar cholangiocarcinoma

Abstract

The preoperative biliary drainage for hilar cholangiocarcinoma can be achieved via percutaneous or endoscopic access, however, there is no clear standard for the choice. Early establishment of the criteria for selection is necessary. In this study, we compared the periods from hospitalization to surgical operation and the complication rate of cholangitis according to the drainage method for hilar cholangiocarcinoma patients, who underwent a surgical resection at our hospital. In addition, we compared the diagnosis rate for cancer by the histopathological inspection according to the approach method. The complication rate of cholangitis in endoscdopic group were identical for those in percutaneous group, moreover, those in bilateral intrahepatic biliary drainage group and those in unilateral drainage group was also equivalent. The hospitalized period to operation in endoscopic access group was shorter than those in percutaneous access group. The comparison results of the histopathological inspection indicated that the correct diagnosis rates by the cytology, the brushing cytology and the organization biopsy in endoscopic access group were equivalent in percutaneous access group.
These results suggested that endoscopic unilateral drainage is the first-line therapy for the preoperative biliary drainage of hilar cholangiocarcinoma..