An Unsuccessful Randomized Trial of Percutaneous vs Endoscopic Drainage of Suspected Malignant Hilar Obstruction. Clin Gastroenterol Hepatol 2021 Jun;19(6):1282-1284
Date
05/27/2020Pubmed ID
32454259Pubmed Central ID
PMC8776356DOI
10.1016/j.cgh.2020.05.035Scopus ID
2-s2.0-85103976576 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
Percutaneous transhepatic biliary drainage (PTBD) and endoscopic retrograde cholangiopancreatography (ERCP) are widely accepted but competing approaches for the management of malignant obstruction at the hilum of the liver. ERCP is favored in the United States on the basis of high success rates for non-hilar indications, the perceived safety and superior tissue sampling capability of ERCP relative to PTBD, and the avoidance of external drains that are undesirable to patients. A recent randomized controlled trial (RCT) comparing the 2 modalities in patients with resectable hilar cholangiocarcinoma was terminated prematurely because of higher mortality in the PTBD group.1 In contrast, most observational data suggest that PTBD is superior for achieving complete drainage.2-6 Because the preferred procedure remains uncertain, we aimed to compare PTBD and ERCP as the primary intervention in patients with cholestasis due to malignant hilar obstruction (MHO).
Author List
Elmunzer BJ, Smith ZL, Tarnasky P, Wang AY, Yachimski P, Banovac F, Buscaglia JM, Buxbaum J, Chak A, Chong B, Coté GA, Draganov PV, Dua K, Durkalski V, Geller BS, Jamil LH, Keswani RN, Khashab MA, Law R, Lo SK, McCarthy S, Selby JB, Singh VK, Taylor JR, Willingham FF, Spitzer RL, Foster LD, INTERCPT study group and the United States Cooperative for Outcomes Research in Endoscopy (USCORE)Authors
Kulwinder S. Dua MD Professor in the Medicine department at Medical College of WisconsinZachary Smith DO Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Bile Duct NeoplasmsBile Ducts, Intrahepatic
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis
Drainage
Endosonography
Humans