Original Scientific Report

Impact of Biliary Drainage on Multidetector-Row Computed Tomography on R0 Resection of Perihilar Cholangiocarcinoma

Isamu Hosokawa

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Hiroaki Shimizu,

Hiroaki Shimizu

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Hideyuki Yoshitomi,

Hideyuki Yoshitomi

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Katsunori Furukawa,

Katsunori Furukawa

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Tsukasa Takayashiki,

Tsukasa Takayashiki

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Masaru Miyazaki,

Masaru Miyazaki

Mita Hospital, International University of Health and Welfare, Tokyo, Japan

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Masayuki Ohtsuka,

Corresponding Author

Masayuki Ohtsuka

[email protected]
+81-43-226-2103

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

Tel.: +81-43-226-2103, [email protected]Search for more papers by this author

Isamu Hosokawa,

Isamu Hosokawa

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Hiroaki Shimizu,

Hiroaki Shimizu

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Hideyuki Yoshitomi,

Hideyuki Yoshitomi

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Katsunori Furukawa,

Katsunori Furukawa

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Tsukasa Takayashiki,

Tsukasa Takayashiki

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

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Masaru Miyazaki,

Masaru Miyazaki

Mita Hospital, International University of Health and Welfare, Tokyo, Japan

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Masayuki Ohtsuka,

Corresponding Author

Masayuki Ohtsuka

[email protected]
+81-43-226-2103

Department of General Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, 260-0856 Chuo-ku, Chiba, Japan

Tel.: +81-43-226-2103, [email protected]Search for more papers by this author

First published: 11 May 2018

https://doi.org/10.1007/s00268-018-4654-2

Citations: 15

Electronic supplementary material: The online version of this article (https://doi.org/10.1007/s00268-018-4654-2) contains supplementary material, which is available to authorized users.

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Abstract

Background

Although multidetector-row computed tomography (MDCT) before biliary drainage is useful for the assessment of the resectability of perihilar cholangiocarcinoma (PHC), the impact of biliary drainage on MDCT images before surgical resection for PHC has been poorly studied, and its possible consequences for R0 resection of PHC remain unclear. This study was performed to compare the surgical outcomes of patients with PHC who underwent MDCT before versus after biliary drainage.

Methods

All consecutive patients who underwent major hepatectomy extending to segment 1 with extrahepatic bile duct resection for PHC from 2009 to 2016 were retrospectively evaluated. R0 resection was defined as no residual cancer at all surgical margins. Patients with pathological stage IV PHC were excluded.

Results

Of 142 patients who underwent major hepatectomy, 108 were eligible for this study. Of these 108 patients, 64 (59%) and 44 (41%) underwent MDCT before and after biliary drainage, respectively. The total bilirubin concentration at presentation was lower in patients who underwent MDCT before than after biliary drainage (4.1 ± 5.9 vs. 8.0 ± 7.1 mg/ml, respectively; p = 0.002). Although there were no significant differences in the surgical characteristics or pathological stages between the two groups, R0 resection was more frequently achieved in patients who underwent MDCT before than after biliary drainage [46/64 (72%) vs. 22/44 (50%), respectively; p = 0.03]. On multivariate analysis, MDCT before biliary drainage was independently associated with R0 resection of PHC (risk ratio: 2.38, 95% CI 1.05–5.41; p = 0.04).

Conclusions

In selected patients, MDCT should be performed before biliary drainage to achieve R0 resection of PHC.

Supporting Information

References

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Volume42, Issue11

November 2018

Pages 3676-3684

Impact of Biliary Drainage on Multidetector-Row Computed Tomography on R0 Resection of Perihilar Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Information

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Impact of Biliary Drainage on Multidetector-Row Computed Tomography on R0 Resection of Perihilar Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusions

Supporting Information

References

Citing Literature

References

Related

Information