Evidence map›Paper›PMID 31139984›Full record

ArticleSurgical endoscopy2020

Comparing the efficacy of initial percutaneous transhepatic biliary drainage and endoscopic retrograde cholangiopancreatography with stenting for relief of biliary obstruction in unresectable cholangiocarcinoma.

S O'Brien, N Bhutiani, M E Egger, A N Brown, K H Weaver, D Kline, L R Kelly, C R Scoggins, R C G Martin, G C Vitale

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

S O'BrienDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
N BhutianiDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
M E EggerDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
A N BrownDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
K H WeaverDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
D KlineDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
L R KellyDepartment of Radiology, Norton Hospital, Louisville, KY, USA.
C R ScogginsDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
R C G MartinDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA.
G C VitaleDivision of Surgical Oncology, Department of Surgery, University of Louisville, 550 S. Jackson Street, Louisville, KY, 40202, USA. garyvitale@gmail.edu.
University of Louisville · USNorton Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with cholangiocarcinoma (CC), management of biliary obstruction commonly involves either up-front percutaneous transhepatic biliary drainage (PTBD) or initial endoscopic retrograde cholangiopancreatography (ERCP) with stent placement. The objective of the study was to compare the efficacy and of initial ERCP with stent placement with efficacy of initial PTBD in management of biliary obstruction in CC.

methodsA single-center database of patients with unresectable CC treated between 2006 and 2017 was queried for patients with biliary obstruction who underwent either PTBD or ERCP. Groups were compared with respect to patient, tumor, procedure, and outcome variables.

resultsOf 87 patients with unresectable CC and biliary obstruction, 69 (79%) underwent initial ERCP while 18 (21%) underwent initial PTBD. Groups did not differ significantly with respect to age, gender, or tumor location. Initial procedure success did not differ between the groups (94% ERCP vs 89% PTBD, p = 0.339). Total number of procedures did not differ significantly between the two groups (ERCP median = 2 vs. PTC median = 2.5, p = 0.83). 21% of patients required ERCP after PTBD compared to 25% of patients requiring PTBD after ERCP (p = 1.00). Procedure success rate (97% ERCP vs. 93% PTBD, p = 0.27) and rates of cholangitis (22% ERCP vs. 17% PTBD, p = 0.58) were similar between the groups. Number of hospitalizations since initial intervention did not differ significantly between the two groups (ERCP median = 1 vs. PTC median = 3.5, p = 0.052).

conclusionsIn patients with CC and biliary obstruction, initial ERCP with stent placement and initial PTBD both represent safe and effective methods of biliary decompression. Initial ERCP and stenting should be considered for relief of biliary obstruction in such patients in centers with advanced endoscopic capabilities.

Indexed as

StentsAdultAgedAged, 80 and overBile Duct NeoplasmsBile Ducts, IntrahepaticCholangiocarcinomaCholangiopancreatography, Endoscopic RetrogradeCholangitisCholestasisDrainageFemaleHumansJaundice, ObstructiveMaleMiddle AgedCholangiocarcinomaERCPPercutaneous transhepatic biliary drainage

Identifiers

PMID31139984
OpenAlexW2947410572

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.