Drainage through ERCP, PTBD acceptable for preparing patients for curative HC resection

Endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic biliary drainage (PTBD), either alone or in combination, are acceptable for the preoperative management of hilar cholangiocarcinoma (HC) and can help optimize patients for curative HC resection, a recent study has found.

Researchers conducted a retrospective analysis of 86 patients who had undergone curative HC resection in the past 26 years who were divided into three analytic groups according to drainage modality: ERCP alone (group A; n=32), PTBD alone (group B; n=10), and both ERCP and PTBD (group C; n=44). Outcomes included drainage-related and surgical complications, as well as hospital mortality, compared among groups.

Fifty-two patients developed complications after the surgery. Subphrenic abscess, in particular, seemed to be correlated with ERCP, with significantly elevated rates in groups A and C vs B (25 percent and 9.1 percent vs 0 percent; p=0.035).

In addition, wound infection (31.3 percent vs 10 percent and 22.7 percent; p=0.334), chest infection (28.1 percent vs 20 percent and 11.4 percent; p=0.178), and urinary tract infection (6.3 percent vs 0 percent and 0 percent; p=0.133) were all more common in group A vs B and C, respectively, though in all cases, significance was not achieved. All other complications evaluated were statistically comparable across groups.

Similarly, the overall rate of major complications did not differ across groups (p=0.501), nor did the rates of overall (p=0.370) and disease-free (p=0.569) survival.