Background: Preoperative biliary drainage(PBD) for Perihilar cholangiocarcinoma(pCCA) is known to reduce postoperative morbidity after extended liver resection in jaundice patients, But Percutaneous biliary drainage(PTBD) or Endoscopic Nasobiliary drainage(ENBD) has superior results still debate. This study is to compare success rate and complications of each techniques
Methods: Patients with resectable Perihilar cholangiocarcinoma whom present with jaundice between ____2015 to _______50 pateints were randomized into ENBD group and 50 patients PTBD group, after jaundice resolve we perform liver resection. Success rate , procedure associated complication, cost and also quality of life after drainage were analysis
Results: Of the 100 patients with PCCA, 50 ENBD group and 50 PTBD group, there are no different in gender, age, type and staging of tumor. XX% ENBD were fail and rescued PTBD performed, these patient are still analysis in ENBD group. PTBD 100% success(p=0.001). Average time to recovery from jaundice XX days in PTBD and YY day in ENBD(p=0.003). Higher rate of cholangitis, tube occlusion, longer hospital stay and more frequent readmission were found in XX group. Better quality of life found in PTBD groups and also lower cost. Average waiting time to surgery is XX in PTBD and YY in ENBD. There were XX% in PTBD and YY% in ENBD perform preoperative portal vien embolization. XX % were found unresectable YY% in PTBD groups ZZ% in ENBD all receive palliation treatment By pass or SEMS. There were no PTBD tract metastasis. There are no post operative mortality, 20% post operative morbidity, no different between two groups.
Conclusion: PTBD are prefer for Preoperative drainage method because of high success rate, low complication and low risk of tumor tract seeding
Key Words: preoperative biliary drainage; PTBD; ENBD; Perihilar Cholangiocarcinoma;