Tsuboi Tomofumi, Sasaki Tamito, Serikawa Masahiro, Ishii Yasutaka, Mouri Teruo, Shimizu Akinori, Kurihara Keisuke, Tatsukawa Yumiko, Miyaki Eisuke, Kawamura Ryota, Tsushima Ken, Murakami Yoshiaki, Uemura Kenichiro, Chayama Kazuaki
Department of Gastroenterology and Metabolism, Applied Life Science, Institute of Biomedical & Health Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Gastroenterol Res Pract. 2016;2016:7968201. doi: 10.1155/2016/7968201. Epub 2016 Jan 6.
Objective. To elucidate the optimum preoperative biliary drainage method for patients with pancreatic cancer treated with neoadjuvant chemotherapy (NAC). Material and Methods. From January 2010 through December 2014, 20 patients with borderline resectable pancreatic cancer underwent preoperative biliary drainage and NAC with a plastic or metallic stent and received NAC at Hiroshima University Hospital. We retrospectively analyzed delayed NAC and complication rates due to biliary drainage, effect of stent type on perioperative factors, and hospitalization costs from diagnosis to surgery. Results. There were 11 cases of preoperative biliary drainage with plastic stents and nine metallic stents. The median age was 64.5 years; delayed NAC occurred in 9 cases with plastic stent and 1 case with metallic stent (p = 0.01). The complication rates due to biliary drainage were 0% (0/9) with metallic stents and 72.7% (8/11) with plastic stents (p = 0.01). Cumulative rates of complications determined with the Kaplan-Meier method on day 90 were 60% with plastic stents and 0% with metallic stents (log-rank test, p = 0.012). There were no significant differences between group in perioperative factors or hospitalization costs from diagnosis to surgery. Conclusions. Metallic stent implantation may be effective for preoperative biliary drainage for pancreatic cancer treated with NAC.
目的。阐明接受新辅助化疗（NAC）的胰腺癌患者的最佳术前胆道引流方法。材料与方法。2010年1月至2014年12月，20例边界可切除胰腺癌患者在广岛大学医院接受了术前胆道引流及使用塑料或金属支架的NAC治疗。我们回顾性分析了因胆道引流导致的NAC延迟及并发症发生率、支架类型对围手术期因素的影响以及从诊断到手术的住院费用。结果。术前使用塑料支架进行胆道引流的有11例，使用金属支架的有9例。中位年龄为64.5岁；使用塑料支架的9例和使用金属支架的1例出现NAC延迟（p = 0.01）。金属支架的胆道引流并发症发生率为0%（0/9），塑料支架为72.7%（8/11）（p = 0.01）。采用Kaplan-Meier法确定的90天时并发症累积发生率，塑料支架为60%，金属支架为0%（对数秩检验，p = 0.012）。两组在围手术期因素或从诊断到手术的住院费用方面无显著差异。结论。金属支架植入术可能对接受NAC治疗的胰腺癌患者术前胆道引流有效。
