Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction: results of a prospective, randomized, and controlled study

Gastrointestinal Endoscopy
G D De PalmaC Catanzano

Abstract

The necessity for drainage of both liver lobes in tumors arising at the biliary bifurcation is controversial. The aim of this study was to compare the outcome of unilateral versus bilateral drainage in patients with biliary obstruction at the hilum. One hundred fifty-seven consecutive patients with primary cholangiocarcinoma, gallbladder cancer, or periportal lymph node metastases were randomly allocated to unilateral (group A) or bilateral (group B) hepatic duct drainage. In intention-to treat analysis, group A had a significantly higher rate of successful endoscopic stent insertion than group B (88.6% vs. 76.9%, p = 0.041). Group B had a significantly higher rate of complications than group A (26.9% vs. 18.9%, p = 0.026) because of the higher rate of early cholangitis (16.6% vs. 8.8%, p = 0.013). In per-protocol analysis the rate of successful drainage, complications, and mortality did not differ between the two groups. Median survival did not differ between the two groups but was significantly different for patients with cholangiocarcinoma and those with gallbladder cancer versus patients with metastatic tumors (p = 0.0247). The insertion of more than one stent would not appear justified as a routine procedure in patients wi...Continue Reading

Citations

Jan 15, 2004·Current Gastroenterology Reports·Kirsten Muri Boberg, Erik Schrumpf
Apr 17, 2004·Journal of Gastroenterology and Hepatology·V SinghM Gulati
Jun 29, 2004·Journal of Clinical Gastroenterology·Rungsun RerknimitrPinit Kullavanijaya
Aug 8, 2006·Current Opinion in Gastroenterology·Prabhleen Chahal, Todd H Baron
Jan 27, 2006·World Journal of Gastroenterology : WJG·S D MansfieldD Manas
Nov 22, 2007·The American Journal of Gastroenterology·Alberto LarghiGuido Costamagna
Aug 23, 2008·Journal of Clinical Gastroenterology·David G PerdueUNKNOWN ERCP Outcome Study ERCOST Group
Sep 17, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jaap J KloekThomas M van Gulik
Oct 12, 2010·Expert Review of Gastroenterology & Hepatology·Muslim AtiqJeffrey H Lee
Jan 5, 2011·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hirotoshi IwanoIsao Sakaida
Jun 9, 2011·Journal of Gastroenterology and Hepatology·Nobuhisa AkamatsuDaijo Hashimoto
Jun 18, 2011·Journal of Hepato-biliary-pancreatic Sciences·Hirofumi KogureKazuhiko Koike
Mar 12, 2011·Digestive Diseases and Sciences·Harry R Aslanian, Priya A Jamidar
Mar 15, 2012·Journal of Hepato-biliary-pancreatic Sciences·Tsuyoshi MukaiHisataka Moriwaki
Jan 29, 2013·Journal of Gastroenterology and Hepatology·Rungsun RerknimitrUNKNOWN Asia-Pacific Working Group on Hepatobiliary Cancers
Dec 25, 2013·The Journal of International Medical Research·Denghua YaoXiao Li
Sep 19, 2014·World Journal of Hepatology·Mahesh Kr Goenka, Usha Goenka
Jan 27, 2015·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Randhir SudParvesh Kumar Jain
May 7, 2015·World Journal of Gastroenterology : WJG·Ei TakahashiNobuyuki Enomoto
Feb 25, 2015·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Jae Min LeeYong-Tae Kim
Jun 2, 2016·World Journal of Radiology·Kumble Seetharama MadhusudhanArun Kumar Gupta
Oct 29, 2017·Journal of Digestive Diseases·Ming Xing XiaBing Hu
Jul 3, 2018·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Dong Jae ShimKyu-Bo Sung
Oct 20, 2018·Digestive Diseases and Sciences·Daniel S Strand
May 6, 2019·Journal of Surgical Oncology·A Aziz Aadam, Kevin Liu
May 23, 2020·Clinical Endoscopy·Jin Ho Choi, Woo Hyun Paik
Jun 7, 2008·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Boris Blechacz, Gregory J Gores
Feb 16, 2008·Journal of Hepato-biliary-pancreatic Surgery·Toshio TsuyuguchiUNKNOWN Japan Society of Clinical Oncology
Aug 27, 2009·Langenbeck's Archives of Surgery·Franco PiselloCarmelo Sciumè
Feb 14, 2012·Journal of Clinical Gastroenterology·Divyesh Sejpal
Sep 13, 2012·Current Gastroenterology Reports·Halim Charbel, Firas H Al-Kawas
Jan 5, 2011·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yoshihide KannoTakahisa Ogawa
Nov 12, 2013·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Srinivas R PuliDavid Carr-Locke
May 3, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hironari KatoKazuhide Yamamoto
Oct 26, 2013·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Shajan Peter, Charles M Wilcox
Aug 1, 2015·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Martín Alejandro GuidiRaúl Fernando Matanó

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.