Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
J Hepatobiliary Pancreat Sci. 2019 Aug;26(8):341-347. doi: 10.1002/jhbp.640. Epub 2019 Jul 9.
Although there are many studies on technical outcomes of endoscopic nasobiliary drainage (ENBD), no authors reported on preoperative course of patients undergoing ENBD. The aim of this study was to investigate the course of patients with ENBD during the waiting period.
Patients who underwent resection of perihilar cholangiocarcinoma (PHCC) between January 2013 and September 2017 were retrospectively reviewed.
During the study period, 191 consecutive patients underwent surgical resection of PHCC after ENBD. Of the study patients, 154 (80.6%) patients were discharged, returned to their home, then re-admitted for surgery. The remaining 37 patients were continuously hospitalized. The number of cholangitis events during the waiting period was 0 in 120 patients, 1 in 59 patients, 2 ≤ in 12 patients. Endoscopic re-intervention was needed in 52 patients. The median length between the first admission and surgery was 37 days (range 12-197 days) in the entire cohort; it was longer in patients with portal vein embolization than in those without (43 vs. 27 days, P < 0.001).
In patients undergoing resection of PHCC, ENBD is widely tolerable with relatively low incidence of cholangitis and thus recommended for preoperative biliary drainage.
尽管有许多关于内镜鼻胆管引流术（ENBD）技术结果的研究，但没有作者报道过接受 ENBD 的患者的术前过程。本研究旨在探讨接受 ENBD 的患者在等待期间的情况。
回顾性分析 2013 年 1 月至 2017 年 9 月期间接受肝门部胆管癌（PHCC）切除术的患者。
在研究期间，191 例连续患者在接受 ENBD 后接受了 PHCC 的手术切除。在研究患者中，154 例（80.6%）患者出院，返回家中，然后再次入院接受手术。其余 37 例患者持续住院。120 例患者中有 0 例发生胆管炎，59 例有 1 例，12 例有 2 例或更多。52 例需要内镜再次干预。整个队列中，首次入院和手术之间的中位时间为 37 天（范围 12-197 天）；接受门静脉栓塞术的患者比未接受门静脉栓塞术的患者长（43 天比 27 天，P<0.001）。
在接受 PHCC 切除术的患者中，ENBD 广泛耐受，胆管炎发生率相对较低，因此推荐用于术前胆道引流。
