Format

Send to

Choose Destination
Gut Liver. 2019 May 3. doi: 10.5009/gnl18573. [Epub ahead of print]

Clinical Outcomes of Biliary Drainage during a Neoadjuvant Therapy for Pancreatic Cancer: Metal versus Plastic Stents.

Author information

1
Hokkaido Pancreatic Cancer Study Group: HOPS.
2
Department of Gastroenterology and Hepatology, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo 060-8648, Japan.
3
Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Japan 4Center for Gastroenterology, Teine-Keijinkai Hospital, Japan.
4
Center for Gastroenterology, Teine-Keijinkai Hospital, Japan.
5
Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Japan.
6
Department of Medical Oncology, Sapporo Medical University School of Medicine, Japan.
7
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Japan.
8
Department of Surgery, Asahikawa Medical University, Japan.
9
Division of Metabolism and Biosystemic Science, Asahikawa Medical University, Japan.
10
Division of Gastroenterology and Hematology/Oncology, Asahikawa Medical University, Japan.

Abstract

Background/Aims:

Neoadjuvant chemotherapy/neoadjuvant chemoradiotherapy (NAC/NACRT) can be performed in patients with pancreatic cancer to improve survival. We aimed to clarify the clinical outcomes of biliary drainage with a metal stent (MS) or a plastic stent (PS) during NAC/NACRT.

Methods:

Between October 2013 and April 2016, 96 patients with pancreatic cancer were registered for NAC/NACRT. Of these, 29 patients who underwent biliary drainage with MS or PS before NAC/NACRT and a subsequent pancreatoduodenectomy were retrospectively analyzed with regard to patient characteristics, preoperative recurrent biliary obstruction (RBO) rate, NAC/NACRT delay or discontinuation rate, and operative characteristics.

Results:

The median age of the patients was 67 years. NAC and NACRT were performed in 14 and 15 patients, respectively, and MS and PS were used in 17 and 12 patients, respectively. RBO occurred in 6% and 83% of the patients in the MS and PS groups, respectively (p<0.001). NAC/NACRT delay was observed in 35% and 50% of the patients in the MS and PS groups, respectively (p=0.68). NAC/NACRT discontinuation was observed in 12% and 17% of the patients in the MS and PS groups, respectively (p=1). The operative time in the MS group tended to be longer than that in the PS group (625 minutes vs 497 minutes, p=0.0513), and the operative blood loss volumes and postoperative adverse event rates were not different between the two groups.

Conclusions:

MS was better than PS from the viewpoint of preventing RBO, although MS was similar to PS with regards to perioperative outcomes.

KEYWORDS:

Chemoradiotherapy; Chemotherapy; Jaundice; Pancreatic cancer; Stent

PMID:
31060118
DOI:
10.5009/gnl18573
Free full text

Supplemental Content

Full text links

Icon for Inforang
Loading ...
Support Center