Kawakubo K, Kawakami H, Kuwatani M, Haba S, Kudo T, Taya YA, Kawahata S, Kubota Y, Kubo K, Eto K, Ehira N, Yamato H, Onodera M, Sakamoto N. Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma. World J Gastrointest Endosc 2016; 8(9): 385-390 [PMID: 27170839 DOI: 10.4253/wjge.v8.i9.385]
Corresponding Author of This Article
Kazumichi Kawakubo, MD, PhD, Assistant Professor, Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo 0608638, Japan. kkawakubo-gi@umin.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
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/
World J Gastrointest Endosc. May 10, 2016; 8(9): 385-390 Published online May 10, 2016. doi: 10.4253/wjge.v8.i9.385
Table 1 Patient characteristics (N-118)
Age, yr (mean, SD)
69 (9)
Male/female
74/44
Preoperative bilirubin, mg/dL (median, range)
2.0 (0.5–24.9)
Bismuth I/II/IIIa/IIIb/IV, n
18/25/35/5/35
Initial biliary drainage at our institutions, n (%)
43 (36)
Initial drainage ENBD/EBS, n
85/33
Unilateral/bilateral, n
102/16
Sphincterotomy, n (%)
74 (63)
PTPE, n (%)
54 (46)
Surgery, n (%)
71 (60)
Time to surgery, days (median, range)
62 (4-233)
Table 2 Complications
Initial draiange
ENBD (n = 85)
EBS (n = 33)
ENBD dislocation
20
6
EBS occlusion
8
14
ENBD occlusion
14
7
Contralateral cholangitis
25
12
Accidental ENBD extubation
2
2
Cholecystitis
0
3
Liver abscess
0
2
ENBD induced ulcer
0
1
Inappropriate location
1
1
Pancreatitis
12
7
(Mild/moderate/severe)
(5/2/5)
(3/2/2)
Table 3 Risk factors for biliary reintervention
OR
95%CI
P value
Age (+1 yr)
1.01
0.96-1.06
0.626
Female/male
1.23
0.50-3.14
0.650
Bismuth I
1
Bismuth II
1.53
0.38-9.19
0.555
Bismuth IIIa/b/IV
2.06
0.68-6.11
0.195
Preoperative Bil (+ 1 mg/dL)
0.97
0.91-1.05
0.492
EBS/ENBD
3.80
1.32-13.02
0.012
Unilateral/bilateral
2.62
0.74-9.20
0.132
Sphincterotomy
1.32
0.53-3.25
0.551
Table 4 Risk factors for percutaneous transhepatic biliary drainage
OR
95%CI
P value
Age (+1 yr)
0.96
0.92-1.08
0.220
Female/male
2.48
0.73-8.71
0.143
Bismuth I
1
Bismuth II
0.54
0.02-15.15
0.683
Bismuth IIIa/b/IV
10.15
1.62-214.7
0.010
Sphincterotomy
2.36
0.69- 9.43
0.178
EBS/ENBD
2.63
0.70-9.89
0.149
Unilateral/bilateral
8.77
1.09-214.7
0.040
Preoperative bilirubin (+ 1 mg/dL)
1.02
0.93-1.12
0.604
Table 5 Risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis
OR
95%CI
P value
Age (+1 yr)
0.95
0.89-1.01
0.078
Female/male
1.45
0.48-4.36
0.501
EBS/ENBD
2.24
0.70-7.09
0.171
Unilateral/bilateral
1.46
0.31-11.24
0.661
No sphincterotomy
3.46
1.19-10.87
0.023
Citation: Kawakubo K, Kawakami H, Kuwatani M, Haba S, Kudo T, Taya YA, Kawahata S, Kubota Y, Kubo K, Eto K, Ehira N, Yamato H, Onodera M, Sakamoto N. Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma. World J Gastrointest Endosc 2016; 8(9): 385-390