Controversy of preoperative biliary drainage for resectable hilar cholangiocarcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Zhengchen , Chen Xiaoxing ,  WANG Lin

Hepatopancreatobiliary Surgery Dept.2, Second Affiliated Hospital of Kunming Medical University, Kunming 650106, R. P. China;

Corresponding author：

WANG Lin, Email: linwang2019@126.com

Keywords：

hilar cholangiocarcinoma; Klatskin tumor, preoperative biliary drainage;

DOI：

10.7507/1007-9424.201909122

Video：

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Objective To explore the advantages and disadvantages of preoperative biliary drainage, the timing of preoperative biliary drainage, and the characteristics of various drainage methods for resectable hilar cholangiocarcinoma.Methods By reviewing relevant literatures at home and abroad in the past 20 years, the controversies related to the preoperative biliary drainage, surgical biliary drainage, and various drainage methods for resectable hilar cholangiocarcinoma were reviewed.Results There is still a great deal of controversy about whether preoperative bile duct drainage is required for resectable hilar cholangiocarcinoma routinely, but there is a consensus on the timing of preoperative biliary drainage, and various drainage methods have their own characteristics.Conclusions The main treatment for hilar cholangiocarcinoma is radical surgical resection, but cholestasis is often caused by malignant biliary obstruction, which makes it difficult to manage perioperatively. A large number of prospective studies are needed to provide more evidence for the need for routine preoperative biliary drainage in patients with hilar cholangiocarcinoma who can undergo resection.

Citation： YE Zhengchen, Chen Xiaoxing, WANG Lin. Controversy of preoperative biliary drainage for resectable hilar cholangiocarcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(6): 763-767. doi: 10.7507/1007-9424.201909122 Copy

1.	萧嘉铭, 董高宏. 肝门部胆管癌的外科治疗现状. 中国肿瘤外科杂志, 2015, 7(6): 390-393.
2.	刘辰, 姜小清. 肝门部胆管癌根治性切除的可能性评估. 中国普外基础与临床杂志, 2016, 23(11): 1299-1303.
3.	黄志强. 肝门部胆管癌外科治疗的现状与我见. 中国实用外科杂志, 2007, 27(5): 341-346.
4.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-79.
5.	McPherson GA, Benjamin IS, Hodgson HJ, et al. Pre-operative percutaneous transhepatic biliary drainage: the results of a controlled trial. Br J Surg, 1984, 71(5): 371-375.
6.	Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
7.	巩鹏, 王忠裕, 王洪江, 等. SOD 基因转染大鼠肝细胞对胆汁毒性损害的保护. 中国实用外科杂志, 2003, 23(6): 346-347.
8.	董家鸿, 郑树森, 陈孝平, 等. 肝切除术前肝脏储备功能评估的专家共识(2011 版). 中华消化外科杂志, 2011, 10(1): 20-25.
9.	郭晗, 陈朋, 袁鹏, 等. 术前胆道引流对肝门胆管癌术后病人的影响的 Meta 分析. 肝胆外科杂志, 2017, 25(3): 185-189.
10.	Wang Y, Fu W, Tang Z, et al. Effect of preoperative cholangitis on prognosis of patients with hilar cholangiocarcinoma: A systematic review and meta-analysis. Medicine, 2018, 97(34): e12025.
11.	Ribero D, Zimmitti G, Aloia TA, et al. Preoperative cholangitis and future liver remnant volume determine the risk of liver failure in patients undergoing resection for hilar cholangiocarcinoma. J Am Coll Surg, 2016, 223(1): 87-97.
12.	Cassani LS, Chouhan J, Chan C, et al. Biliary decompression in perihilar cholangiocarcinoma improves survival: a single-center retrospective analysis. Dig Dis Sci, 2019, 64(2): 561-569.
13.	Wang L, Yu WF. Obstructive jaundice and perioperative management. Acta Anaesthesiol Taiwan, 2014, 52(1): 22-29.
14.	国际肝胆胰学会中国分会, 中华医学会外科学分会肝脏外科学组. 胆管癌诊断与治疗-外科专家共识. 临床肝胆病杂志, 2015, 31(1): 12-16.
15.	Nimura Y. Preoperative biliary drainage before resection for cholangiocarcinoma (Pro). HPB (Oxford), 2008, 10(2): 130-133.
16.	Makino H, Shimizu H, Ito H, et al. Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy. World J Gastroenterol, 2006, 12(13): 2053-2059.
17.	Ramanathan R, Borrebach J, Tohme S, et al. Preoperative biliary drainage is associated with increased complications after liver resection for proximal cholangiocarcinoma. J Gastrointest Surg, 2018, 22(11): 1950-1957.
18.	Wahab MA, El Hanafy E, El Nakeeb A, et al. Postoperative outcome after major liver resection in jaundiced patients with proximal bile duct cancer without preoperative biliary drainage. Dig Surg, 2015, 32(6): 426-432.
19.	Xiong JJ, Nunes QM, Huang W, et al. Preoperative biliary drainage in patients with hilar cholangiocarcinoma undergoing major hepatectomy. World J Gastroenterol, 2013, 19(46): 8731-8739.
20.	Cai Y, Tang Q, Xiong, X, et al. Preoperative biliary drainage versus direct surgery for perihilar cholangiocarcinoma: A retrospective study at a single center. Biosci Trends, 2017, 11(3): 319-325.
21.	Sewnath ME, Karsten TM, Prins MH, et al. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Ann Surg, 2002, 236(1): 17-27.
22.	金昌国, 杨滔, 董家鸿. 肝门部胆管癌大范围肝切除术前胆道引流作用的临床研究. 军事医学, 2013, 37(7): 529-534.
23.	Mansour JC, Aloia TA, Crane CH, et al. Hilar cholangiocarcinoma: expert consensus statement. HPB (Oxford), 2015, 17(8): 691-699.
24.	郑树国, 郑树国, 项灿宏, 等. 肝门部胆管癌诊断和治疗指南(2013 版). 中华外科杂志, 2013, 51(10): 865-871.
25.	中国抗癌协会. 肝门部胆管癌规范化诊治专家共识(2015). 中华肝胆外科杂志, 2015, 21(8): 505-511.
26.	Zhang XF, Beal EW, Merath K, et al. Oncologic effects of preoperative biliary drainage in resectable hilar cholangio-carcinoma: percutaneous biliary drainage has no adverse effects on survival. J Surg Oncol, 2018, 117(6): 1267-1277.
27.	Hirano S, Tanaka E, Tsuchikawa T, et al. Oncological benefit of preoperative endoscopic biliary drainage in patients with hilar cholangiocarcinoma. J Hepatobiliary Pancreat Sci, 2014, 21(8): 533-540.
28.	Al Mahjoub A, Menahem B, Fohlen A, et al. Preoperative biliary drainage in patients with resectable perihilar cholangiocarcinoma: is percutaneous transhepatic biliary drainage safer and more effective than endoscopic biliary drainage? A meta-analysis. J Vasc Interv Radiol, 2017, 28(4): 576-582.
29.	Tang Z, Yang Y, Meng W, et al. Best option for preoperative biliary drainage in Klatskin tumor: A systematic review and meta-analysis. Medicine (Baltimore), 2017, 96(43): e8372.
30.	Liu JG, Wu J, Wang J, et al. Endoscopic biliary drainage versus percutaneous transhepatic biliary drainage in patients with resectable hilar cholangiocarcinoma: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech, 2018, 28(9): 1053-1060.
31.	Hameed A, Pang T, Chiou J, et al. Percutaneous vs. endoscopic pre-operative biliary drainage in hilar cholangiocarcinoma-a systematic review and meta-analysis. HPB (Oxford), 2016, 18(5): 400-410.
32.	Wang C, Xu Y, Lu X. Should preoperative biliary drainage be routinely performed for obstructive jaundice with resectable tumor? Hepatobiliary Surg Nutr, 2013, 2(5): 266-271.
33.	Jo JH, Chung MJ, Han DH, et al. Best options for preoperative biliary drainage in patients with Klatskin tumors. Surg Endosc, 2017, 31(1): 422-429.
34.	Kawakami H, Kuwatani M, Onodera M, et al. Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma. J Gastroenterol, 2011, 46(2): 242-248.
35.	Higuchi R, Yazawa T, Uemura S, et al. ENBD is associated with decreased tumor dissemination compared to PTBD in perihilar cholangiocarcinoma. J Gastrointest Surg, 2017, 21(9): 1506-1514.
36.	张辉, 张振, 张海涛, 等. 肝门部胆管癌根治术前经内镜鼻胆管引流和经皮经肝胆管造影引流术的临床效果观察. 腹部外科, 2017, 30(3): 197-201.
37.	Kang MJ, Choi YS, Jang JY, et al. Catheter tract recurrence after percutaneous biliary drainage for hilar cholangiocarcinoma. World J Surg, 2013, 37(2): 437-442.
38.	Paik WH, Loganathan N, Hwang JH. Preoperative biliary drainage in hilar cholangiocarcinoma: when and how? World J Gastrointest Endosc, 2014, 6(3): 68-73.
39.	Komaya K, Ebata T, Yokoyama Y, et al. Verification of the oncologic inferiority of percutaneous biliary drainage to endoscopic drainage: a propensity score matching analysis of resectable perihilar cholangiocarcinoma. Surgery, 2017, 161(2): 394-404.

1. 萧嘉铭, 董高宏. 肝门部胆管癌的外科治疗现状. 中国肿瘤外科杂志, 2015, 7(6): 390-393.
2. 刘辰, 姜小清. 肝门部胆管癌根治性切除的可能性评估. 中国普外基础与临床杂志, 2016, 23(11): 1299-1303.
3. 黄志强. 肝门部胆管癌外科治疗的现状与我见. 中国实用外科杂志, 2007, 27(5): 341-346.
4. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-79.
5. McPherson GA, Benjamin IS, Hodgson HJ, et al. Pre-operative percutaneous transhepatic biliary drainage: the results of a controlled trial. Br J Surg, 1984, 71(5): 371-375.
6. Pavlidis ET, Pavlidis TE. Pathophysiological consequences of obstructive jaundice and perioperative management. Hepatobiliary Pancreat Dis Int, 2018, 17(1): 17-21.
7. 巩鹏, 王忠裕, 王洪江, 等. SOD 基因转染大鼠肝细胞对胆汁毒性损害的保护. 中国实用外科杂志, 2003, 23(6): 346-347.
8. 董家鸿, 郑树森, 陈孝平, 等. 肝切除术前肝脏储备功能评估的专家共识(2011 版). 中华消化外科杂志, 2011, 10(1): 20-25.
9. 郭晗, 陈朋, 袁鹏, 等. 术前胆道引流对肝门胆管癌术后病人的影响的 Meta 分析. 肝胆外科杂志, 2017, 25(3): 185-189.
10. Wang Y, Fu W, Tang Z, et al. Effect of preoperative cholangitis on prognosis of patients with hilar cholangiocarcinoma: A systematic review and meta-analysis. Medicine, 2018, 97(34): e12025.
11. Ribero D, Zimmitti G, Aloia TA, et al. Preoperative cholangitis and future liver remnant volume determine the risk of liver failure in patients undergoing resection for hilar cholangiocarcinoma. J Am Coll Surg, 2016, 223(1): 87-97.
12. Cassani LS, Chouhan J, Chan C, et al. Biliary decompression in perihilar cholangiocarcinoma improves survival: a single-center retrospective analysis. Dig Dis Sci, 2019, 64(2): 561-569.
13. Wang L, Yu WF. Obstructive jaundice and perioperative management. Acta Anaesthesiol Taiwan, 2014, 52(1): 22-29.
14. 国际肝胆胰学会中国分会, 中华医学会外科学分会肝脏外科学组. 胆管癌诊断与治疗-外科专家共识. 临床肝胆病杂志, 2015, 31(1): 12-16.
15. Nimura Y. Preoperative biliary drainage before resection for cholangiocarcinoma (Pro). HPB (Oxford), 2008, 10(2): 130-133.
16. Makino H, Shimizu H, Ito H, et al. Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy. World J Gastroenterol, 2006, 12(13): 2053-2059.
17. Ramanathan R, Borrebach J, Tohme S, et al. Preoperative biliary drainage is associated with increased complications after liver resection for proximal cholangiocarcinoma. J Gastrointest Surg, 2018, 22(11): 1950-1957.
18. Wahab MA, El Hanafy E, El Nakeeb A, et al. Postoperative outcome after major liver resection in jaundiced patients with proximal bile duct cancer without preoperative biliary drainage. Dig Surg, 2015, 32(6): 426-432.
19. Xiong JJ, Nunes QM, Huang W, et al. Preoperative biliary drainage in patients with hilar cholangiocarcinoma undergoing major hepatectomy. World J Gastroenterol, 2013, 19(46): 8731-8739.
20. Cai Y, Tang Q, Xiong, X, et al. Preoperative biliary drainage versus direct surgery for perihilar cholangiocarcinoma: A retrospective study at a single center. Biosci Trends, 2017, 11(3): 319-325.
21. Sewnath ME, Karsten TM, Prins MH, et al. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Ann Surg, 2002, 236(1): 17-27.
22. 金昌国, 杨滔, 董家鸿. 肝门部胆管癌大范围肝切除术前胆道引流作用的临床研究. 军事医学, 2013, 37(7): 529-534.
23. Mansour JC, Aloia TA, Crane CH, et al. Hilar cholangiocarcinoma: expert consensus statement. HPB (Oxford), 2015, 17(8): 691-699.
24. 郑树国, 郑树国, 项灿宏, 等. 肝门部胆管癌诊断和治疗指南(2013 版). 中华外科杂志, 2013, 51(10): 865-871.
25. 中国抗癌协会. 肝门部胆管癌规范化诊治专家共识(2015). 中华肝胆外科杂志, 2015, 21(8): 505-511.
26. Zhang XF, Beal EW, Merath K, et al. Oncologic effects of preoperative biliary drainage in resectable hilar cholangio-carcinoma: percutaneous biliary drainage has no adverse effects on survival. J Surg Oncol, 2018, 117(6): 1267-1277.
27. Hirano S, Tanaka E, Tsuchikawa T, et al. Oncological benefit of preoperative endoscopic biliary drainage in patients with hilar cholangiocarcinoma. J Hepatobiliary Pancreat Sci, 2014, 21(8): 533-540.
28. Al Mahjoub A, Menahem B, Fohlen A, et al. Preoperative biliary drainage in patients with resectable perihilar cholangiocarcinoma: is percutaneous transhepatic biliary drainage safer and more effective than endoscopic biliary drainage? A meta-analysis. J Vasc Interv Radiol, 2017, 28(4): 576-582.
29. Tang Z, Yang Y, Meng W, et al. Best option for preoperative biliary drainage in Klatskin tumor: A systematic review and meta-analysis. Medicine (Baltimore), 2017, 96(43): e8372.
30. Liu JG, Wu J, Wang J, et al. Endoscopic biliary drainage versus percutaneous transhepatic biliary drainage in patients with resectable hilar cholangiocarcinoma: a systematic review and meta-analysis. J Laparoendosc Adv Surg Tech, 2018, 28(9): 1053-1060.
31. Hameed A, Pang T, Chiou J, et al. Percutaneous vs. endoscopic pre-operative biliary drainage in hilar cholangiocarcinoma-a systematic review and meta-analysis. HPB (Oxford), 2016, 18(5): 400-410.
32. Wang C, Xu Y, Lu X. Should preoperative biliary drainage be routinely performed for obstructive jaundice with resectable tumor? Hepatobiliary Surg Nutr, 2013, 2(5): 266-271.
33. Jo JH, Chung MJ, Han DH, et al. Best options for preoperative biliary drainage in patients with Klatskin tumors. Surg Endosc, 2017, 31(1): 422-429.
34. Kawakami H, Kuwatani M, Onodera M, et al. Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma. J Gastroenterol, 2011, 46(2): 242-248.
35. Higuchi R, Yazawa T, Uemura S, et al. ENBD is associated with decreased tumor dissemination compared to PTBD in perihilar cholangiocarcinoma. J Gastrointest Surg, 2017, 21(9): 1506-1514.
36. 张辉, 张振, 张海涛, 等. 肝门部胆管癌根治术前经内镜鼻胆管引流和经皮经肝胆管造影引流术的临床效果观察. 腹部外科, 2017, 30(3): 197-201.
37. Kang MJ, Choi YS, Jang JY, et al. Catheter tract recurrence after percutaneous biliary drainage for hilar cholangiocarcinoma. World J Surg, 2013, 37(2): 437-442.
38. Paik WH, Loganathan N, Hwang JH. Preoperative biliary drainage in hilar cholangiocarcinoma: when and how? World J Gastrointest Endosc, 2014, 6(3): 68-73.
39. Komaya K, Ebata T, Yokoyama Y, et al. Verification of the oncologic inferiority of percutaneous biliary drainage to endoscopic drainage: a propensity score matching analysis of resectable perihilar cholangiocarcinoma. Surgery, 2017, 161(2): 394-404.

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Controversy of preoperative biliary drainage for resectable hilar cholangiocarcinoma

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