| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Comparative Evaluation of Percutaneous Transhepatic Biliary Drainage and Endoscopic Ultrasound-Guided Biliary Drainage for Preoperative Management of Malignant Distal Bile Duct Obstruction After Failed ERCP: A Multicenter Retrospective Analysis. |
| 掲載誌名 | 正式名：Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 略 称：Dig Endosc ISSNコード：14431661/09155635 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Masahiro Itonaga, Mamoru Takenaka, Hideyuki Shiomi, Koh Kitagawa, Shuhei Shintani, Hirotsugu Maruyama, Ryota Sagami, Tsukasa Ikeura, Takeshi Ogura, Yusuke Ishida, Koichiro Mandai, Satoshi Sugimori, Yoshiki Imamura, Atsuhiro Masuda, Kenji Ikezawa, Atsushi Shimizu, Atsushi Nakai, Minako Nagai, Ryota Nakano, Ke Wan, Toshio Shimokawa, Masayuki Kitano |
| 発行年月 | 2025/10 |
| 概要 | OBJECTIVES:This multicenter retrospective study aimed to compare surgery-related adverse events (AEs) of percutaneous transhepatic biliary drainage (PTBD) with those of endoscopic ultrasound-guided biliary drainage (EUS-BD) for preoperative management of malignant distal bile duct obstruction (MDBO).METHODS:We reviewed data from 15 centers in Japan between 2012 and 2021. Patients with MDBO who underwent PTBD or EUS-BD after failed endoscopic retrograde cholangiopancreatography (ERCP) and later underwent pancreaticoduodenectomy (PD) were included. The primary outcome was surgery-related AEs. Secondary outcomes included drainage-related outcomes, surgery-related outcomes, disease-free survival (DFS), and overall survival (OS). Risk factors associated with surgery-related AEs were also evaluated.RESULTS:In total, 2350 patients received biliary drainage before PD. Of the 73 patients in whom ERCP failed, 65 underwent PTBD and 11 underwent EUS-BD. EUS-BD showed a significantly higher internalization rate (100% vs. 28%, p < 0.001), fewer sessions (median 1 vs. 2, p = 0.006), and shorter hospital stay (10 vs. 22 days, p = 0.002). Surgery-related AEs were similar between groups. In the multivariate analysis, age ≥ 71 years and ASA-PS ≥ 2 were identified as significant risk factors for surgery-related AEs, whereas the drainage method was not a significant factor. No significant differences were observed in DFS or OS between the groups.CONCLUSIONS:Surgical-related outcomes, DFS, and OS after EUS-BD were comparable to those after PTBD; however, EUS-BD allowed a higher internalization rate, fewer sessions, and a shorter hospital stay, making it the preferred option for preoperative biliary drainage after failed ERCP. |
| DOI | 10.1111/den.70048 |
| PMID | 41126590 |