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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 8 - 14 (7page)
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Palliation of jaundice improves the general health of the patient and, therefore, surgical outcomes. Because of the complexity and location of strictures, especially proximally, drainage has been accompanied by increased morbidity due to sepsis. Another concern is the provocation of an inflammatory and fibrotic reaction around the area of stent placement. Preoperative biliary drainage with self-expanding metallic stent (SEMS) insertion can be achieved via a percutaneous method or through endoscopic retrograde cholangiopancreatography. A recently published multicenter randomized Dutch study has shown increased morbidity with preoperative biliary drainage. A Cochrane meta-analysis has also shown a significantly increased complication rate with preoperative drainage. However, few of these studies have used a SEMS, which allows better biliary drainage. No randomized controlled trials have compared preoperative deployment of SEMS versus conventional plastic stents. The outcomes of biliary drainage also depend on the location of the obstruction, namely the difficulty with proximal compared to distal strictures. Pathophysiologically, palliation of jaundice will benefit all patients awaiting surgery. However, preoperative drainage often results in increased morbidity because of procedure-related sepsis. The use of SEMS may change the outcome of preoperative biliary drainage dramatically.
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등록된 정보가 없습니다.
참고문헌 (23)
참고문헌 신청
Ayaru L / 2008 / Complications and diagnostic difficulties arising from biliary self-expanding metal stent insertion before definitive histological diagnosis / J Gastroenter
Belghiti J / 2005 / Preoperative optimization of the liver for resection in patients with hilar cholangiocarcinoma / HPB 7 : 252 ~ 253
Coss A / 2009 / Preoperative biliary drainage in malignant obstruction: indications, techniques, and the debate over risk / Curr Gastroenterol Rep 11 : 145 ~ 149
Davids PH / 1992 / Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction / Lancet 340 : 1488 ~ 1492
Fang Y / 2012 / Pre-operative biliary drainage for obstructive jaundice / Cochrane Database Syst Rev 9 : CD005444 ~
Belghiti J / 2005 / Preoperative optimization of the liver for resection in patients with hilar cholangiocarcinoma / HPB 7 : 252 ~ 253
Coss A / 2009 / Preoperative biliary drainage in malignant obstruction: indications, techniques, and the debate over risk / Curr Gastroenterol Rep 11 : 145 ~ 149
Davids PH / 1992 / Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction / Lancet 340 : 1488 ~ 1492
Fang Y / 2012 / Pre-operative biliary drainage for obstructive jaundice / Cochrane Database Syst Rev 9 : CD005444 ~
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