Paik WH, Loganathan N, Hwang JH. Preoperative biliary drainage in hilar cholangiocarcinoma: When and how? World J Gastrointest Endosc 2014; 6(3): 68-73 [PMID: 24634710 DOI: 10.4253/wjge.v6.i3.68]
Corresponding Author of This Article
Jin-Hyeok Hwang, MD, PhD, Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. woltoong@snu.ac.kr
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Woo Hyun Paik, Nerenthran Loganathan, Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Jin-Hyeok Hwang, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do 463-707, South Korea
Author contributions: Paik WH reviewed the literature, and wrote and revised the manuscript; Loganathan N wrote and revised the manuscript; Hwang JH contributed to the conceptual design and critical revision of the manuscript.
Correspondence to: Jin-Hyeok Hwang, MD, PhD, Professor, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, South Korea. woltoong@snu.ac.kr
Telephone: +82-31-7877017 Fax: +82-31-7874051
Received: November 25, 2013 Revised: February 11, 2014 Accepted: March 3, 2014 Published online: March 16, 2014 Processing time: 108 Days and 10.4 Hours
Core Tip
Core tip: In selected patients, optimal preoperative management will improve the morbidity and mortality of hilar cholangiocarcinoma. Endoscopic nasobiliary drainage seems to be the most appropriate method of preoperative biliary drainage (PBD) in terms of minimizing the risk of tract seeding and inflammatory reactions. Percutaneous transhepatic biliary drainage could be a better option in certain cases such as advanced hilar cholangiocarcinoma or segmental cholangitis. Total biliary drainage is not usually recommended except in certain situations when the surgical technique is difficult without PBD or when patients develop cholangitis after unilateral drainage or a slow-resolving hyperbilirubinemia. Although the optimal preoperative bilirubin level is still a matter of debate, the shortest possible duration of PBD is recommended.
