ArticleEndoscopy2015
Preoperative biliary drainage in perihilar cholangiocarcinoma: identifying patients who require percutaneous drainage after failed endoscopic drainage.
Article in Endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 50 citations in OpenAlex.
- An Unsuccessful Randomized Trial of Percutaneous vs Endoscopic Drainage of Suspected Malignant Hilar Obstruction.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Trial
- Association of bilirubin reduction rate after percutaneous transhepatic cholangiographic drainage with major complications in hilar cholangiocarcinoma.BMC gastroenterology · 2026Article
- Primary percutaneous stenting for palliative biliary drainage of patients with malignant hilar biliary obstruction: TESLA trial.JHEP reports : innovation in hepatology · 2025Article
- Endoscopic Biliary Drainage in Malignant Biliary Strictures: A Prospective Analysis Based on Real-World Data.Gastroenterology research · 2025Article
- Article
- Correlation between liver volume drainage and clinical success after endoscopic biliary drainage of hilar malignant obstruction.Clinics (Sao Paulo, Brazil) · 2025Article
- Radiological biliary intervention for stone disease.Annals of gastroenterology · 2025Review
- Acute cholangitis withWorld journal of clinical cases · 2024Article
- Outcome of patients with perihilar cholangiocarcinoma and previous biliary instrumentation: an observational study.BMC gastroenterology · 2024Observational
- National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma.World journal of gastroenterology · 2024Review
- Percutaneous transhepatic biliary drainage for biliary obstruction in perihilar cholangiocarcinoma: a 10-year analysis of safety and outcomes using the CCI index.Langenbeck's archives of surgery · 2023Observational
- Results of endoscopic biliary drainage in patients with malignant hilar stricture.Clinics (Sao Paulo, Brazil) · 2023Article
- Preoperative Management of Perihilar Cholangiocarcinoma.Cancers · 2022Review
- Endoscopic or percutaneous biliary drainage in hilar cholangiocarcinoma: When and how?World journal of gastrointestinal oncology · 2021Review
- The role of stent placement above the papilla (inside-stent) as a bridging therapy for perihilar biliary malignancy: an initial experience.Surgery today · 2021Article
- A Retrospective Study of Biliary Drainage Strategies for Patients with Malignant Hilar Biliary Strictures.Cancer management and research · 2021Article
- Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma.Annals of surgical oncology · 2020Article
- Comparing the efficacy of initial percutaneous transhepatic biliary drainage and endoscopic retrograde cholangiopancreatography with stenting for relief of biliary obstruction in unresectable cholangiocarcinoma.Surgical endoscopy · 2020Article
- Management Strategies for Patients with Hilar Cholangiocarcinomas: Challenges and Solutions.Hepatic medicine : evidence and research · 2020Review
- Postbiliary drainage rates of cholangitis are impacted by procedural technique for patients with supra-ampullary cholangiocarcinoma: A SEER-Medicare analysis.Journal of surgical oncology · 2019Article
Corrections and comments
- Commented on by[Not Available].2015
Authors and funding
19 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND STUDY
aimsPreoperative biliary drainage is often initiated with endoscopic retrograde cholangiopancreatography (ERCP) in patients with potentially resectable perihilar cholangiocarcinoma (PHC), but additional percutaneous transhepatic catheter (PTC) drainage is frequently required. This study aimed to develop and validate a prediction model to identify patients with a high risk of inadequate ERCP drainage. PATIENTS AND
methodsPatients with potentially resectable PHC and (attempted) preoperative ERCP drainage were included from two specialty center cohorts between 2001 and 2013. Indications for additional PTC drainage were failure to place an endoscopic stent, failure to relieve jaundice, cholangitis, or insufficient drainage of the future liver remnant. A prediction model was derived from the European cohort and externally validated in the USA cohort.
resultsOf the 288 patients, 108 (38%) required additional preoperative PTC drainage after inadequate ERCP drainage. Independent risk factors for additional PTC drainage were proximal biliary obstruction on preoperative imaging (Bismuth 3 or 4) and predrainage total bilirubin level. The prediction model identified three subgroups: patients with low risk (7%), moderate risk (40%), and high risk (62%). The high-risk group consisted of patients with a total bilirubin level above 150 µmol/L and Bismuth 3a or 4 tumors, who typically require preoperative drainage of the angulated left bile ducts. The prediction model had good discrimination (area under the curve 0.74) and adequate calibration in the external validation cohort.
conclusionsSelected patients with potentially resectable PHC have a high risk (62%) of inadequate preoperative ERCP drainage requiring additional PTC drainage. These patients might do better with initial PTC drainage instead of ERCP.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.