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Preoperative Cholangitis Affects Survival Outcome in Patients with Extrahepatic Bile Duct Cancer.
J Gastrointest Surg. 2017 06; 21(6):983-989.JG

Abstract

BACKGROUND

It remains controversial whether preoperative cholangitis affects long-term outcomes after resection in patients with extrahepatic bile duct cancer.

METHODS

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.

RESULTS

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.

CONCLUSION

Preoperative cholangitis is an independent prognostic factor in patients with extrahepatic bile duct cancer regardless of the severity of the cholangitis.

Authors+Show Affiliations

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.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. ajiki@med.kobe-u.ac.jp.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.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.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.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.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.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.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.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.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28290140

Citation

Akita, Masayuki, et al. "Preoperative Cholangitis Affects Survival Outcome in Patients With Extrahepatic Bile Duct Cancer." Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, vol. 21, no. 6, 2017, pp. 983-989.
Akita M, Ajiki T, Matsumoto T, et al. Preoperative Cholangitis Affects Survival Outcome in Patients with Extrahepatic Bile Duct Cancer. J Gastrointest Surg. 2017;21(6):983-989.
Akita, M., Ajiki, T., Matsumoto, T., Shinozaki, K., Goto, T., Asari, S., Toyama, H., Kido, M., Fukumoto, T., & Ku, Y. (2017). Preoperative Cholangitis Affects Survival Outcome in Patients with Extrahepatic Bile Duct Cancer. Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract, 21(6), 983-989. https://doi.org/10.1007/s11605-017-3388-z
Akita M, et al. Preoperative Cholangitis Affects Survival Outcome in Patients With Extrahepatic Bile Duct Cancer. J Gastrointest Surg. 2017;21(6):983-989. PubMed PMID: 28290140.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative Cholangitis Affects Survival Outcome in Patients with Extrahepatic Bile Duct Cancer. AU - Akita,Masayuki, AU - Ajiki,Tetsuo, AU - Matsumoto,Taku, AU - Shinozaki,Kenta, AU - Goto,Tadahiro, AU - Asari,Sadaki, AU - Toyama,Hirochika, AU - Kido,Masahiro, AU - Fukumoto,Takumi, AU - Ku,Yonson, Y1 - 2017/03/13/ PY - 2016/11/18/received PY - 2017/02/20/accepted PY - 2017/3/16/pubmed PY - 2018/1/27/medline PY - 2017/3/15/entrez KW - Bile duct cancer KW - Preoperative cholangitis KW - Prognosis SP - 983 EP - 989 JF - Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract JO - J Gastrointest Surg VL - 21 IS - 6 N2 - BACKGROUND: It remains controversial whether preoperative cholangitis affects long-term outcomes after resection in patients with extrahepatic bile duct cancer. METHODS: 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. RESULTS: 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. CONCLUSION: Preoperative cholangitis is an independent prognostic factor in patients with extrahepatic bile duct cancer regardless of the severity of the cholangitis. SN - 1873-4626 UR - https://www.unboundmedicine.com/medline/citation/28290140/Preoperative_Cholangitis_Affects_Survival_Outcome_in_Patients_with_Extrahepatic_Bile_Duct_Cancer_ L2 - https://dx.doi.org/10.1007/s11605-017-3388-z DB - PRIME DP - Unbound Medicine ER -