Akita Masayuki, Ajiki Tetsuo, Matsumoto Taku, Shinozaki Kenta, Goto Tadahiro, Asari Sadaki, Toyama Hirochika, Kido Masahiro, Fukumoto Takumi, Ku Yonson
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
J Gastrointest Surg. 2017 Jun;21(6):983-989. doi: 10.1007/s11605-017-3388-z. Epub 2017 Mar 13.
It remains controversial whether preoperative cholangitis affects long-term outcomes after resection in patients with extrahepatic bile duct cancer.
A total of 107 patients with extrahepatic bile duct cancer who underwent resection with curative intent from 2008 to 2014 were retrospectively reviewed. Patients were categorized into two groups according to the presence or absence of preoperative cholangitis. Clinicopathological variables and long-term outcomes were compared in the two groups.
In the preoperative cholangitis group, the rate of preoperative biliary drainage, the number of tube changes and/or additions, and the rate of lymph node metastasis were higher compared to the no-cholangitis group. Overall survival and disease-free survival were significantly worse in the cholangitis group compared to the no-cholangitis group (p = 0.022, p = 0.007). A poorer prognosis was not observed with an increasing grade of cholangitis in Tokyo Guidelines 2013 (p = 0.09). A multivariate logistic regression analysis revealed that the preoperative cholangitis was an independent prognostic factor for extrahepatic bile duct cancer.
Preoperative cholangitis is an independent prognostic factor in patients with extrahepatic bile duct cancer regardless of the severity of the cholangitis.
术前胆管炎是否会影响肝外胆管癌患者切除术后的长期预后仍存在争议。
回顾性分析了2008年至2014年期间共107例行根治性切除的肝外胆管癌患者。根据术前是否存在胆管炎将患者分为两组。比较两组的临床病理变量和长期预后。
术前胆管炎组与无胆管炎组相比，术前胆道引流率、置管更换和/或增加次数以及淋巴结转移率更高。胆管炎组的总生存期和无病生存期明显差于无胆管炎组（p = 0.022，p = 0.007）。2013年东京指南中胆管炎分级增加并未观察到预后更差（p = 0.09）。多因素逻辑回归分析显示，术前胆管炎是肝外胆管癌的独立预后因素。
术前胆管炎是肝外胆管癌患者的独立预后因素，与胆管炎的严重程度无关。
