Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction
Purposes The advantages of surgical bypass for patients with distal biliary obstruction caused by advanced periampullary cancer include a low risk of recurrent biliary obstruction; however, the highly invasive nature of the operation limits its use. Herein, we present the clinical findings of patien...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2022-11, Vol.52 (11), p.1568-1575 |
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| creator | Kim, Eun Young Lee, Soo Ho Hong, Tae Ho |
| description | Purposes
The advantages of surgical bypass for patients with distal biliary obstruction caused by advanced periampullary cancer include a low risk of recurrent biliary obstruction; however, the highly invasive nature of the operation limits its use. Herein, we present the clinical findings of patients who underwent laparoscopic Roux-en-Y choledochojejunostomy (LRYCJ) compared with those who underwent endoscopic stent insertion.
Methods
We reviewed, retrospectively, the palliative care outcomes for malignant bile duct obstruction according to the type of intervention: LRYCJ vs. endoscopic stenting. After initial intervention, the factors predisposing to recurrent biliary obstruction (RBO) were identified via multiple regression analysis.
Results
The final analysis included 28 patients treated with LRYCJ (22.4%) and 97 patients who underwent endoscopic stent insertion (77.6%). The two groups did not differ in the incidence of early or late complications and mortality; however, the LRYCJ group had a lower incidence of RBO (4 patients, 14.3% vs. 73 patients, 75.3%;
p
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| doi_str_mv | 10.1007/s00595-022-02513-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2661956055</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2661956055</sourcerecordid><originalsourceid>FETCH-LOGICAL-c348t-e9e173d1e8538b5c1f51ff8ea149268feaa915e218707d010668c314d8dca603</originalsourceid><addsrcrecordid>eNp9kE9rHDEMxU1pIds0XyAnH3NxK9njWc-xhP6DQEvIJSfj9WhSL57xxPaU5pSvXqfbcw9CIN6Tnn6MXSK8R4D9hwKgBy1AylYalTCv2A471QtpUL1mOxg6FCgHPGNvSzkCyM4A7NjzDxdjcDX8Ih7d6nIqPq3B89u0_Ra0iHvuf6ZIY2rtSMdtSaWm-Ym7wh2fyJVwiMRrJldnWipPaw1p4VPKfHYxPCyuDcdQqov8ENqp_MTTodS8-RfhO_ZmcrHQxb9-zu4-f7q7_ipuvn_5dv3xRnjVmSpoINyrEcloZQ7a46Rxmgw57AbZm5bDDahJotnDfgSEvjdeYTea0bse1Dm7Oq1dc3rcqFQ7h-IpRrdQ2oqVfY-D7kHrJpUnqW8sSqbJrjnMLbZFsC-w7Qm2bbDtX9jWNJM6mUoTLw-U7TFteWkf_c_1B1n6hU8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2661956055</pqid></control><display><type>article</type><title>Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction</title><source>SpringerLink Journals - AutoHoldings</source><creator>Kim, Eun Young ; Lee, Soo Ho ; Hong, Tae Ho</creator><creatorcontrib>Kim, Eun Young ; Lee, Soo Ho ; Hong, Tae Ho</creatorcontrib><description>Purposes
The advantages of surgical bypass for patients with distal biliary obstruction caused by advanced periampullary cancer include a low risk of recurrent biliary obstruction; however, the highly invasive nature of the operation limits its use. Herein, we present the clinical findings of patients who underwent laparoscopic Roux-en-Y choledochojejunostomy (LRYCJ) compared with those who underwent endoscopic stent insertion.
Methods
We reviewed, retrospectively, the palliative care outcomes for malignant bile duct obstruction according to the type of intervention: LRYCJ vs. endoscopic stenting. After initial intervention, the factors predisposing to recurrent biliary obstruction (RBO) were identified via multiple regression analysis.
Results
The final analysis included 28 patients treated with LRYCJ (22.4%) and 97 patients who underwent endoscopic stent insertion (77.6%). The two groups did not differ in the incidence of early or late complications and mortality; however, the LRYCJ group had a lower incidence of RBO (4 patients, 14.3% vs. 73 patients, 75.3%;
p
< 0.001). As a predisposing factor for RBO, endoscopic stenting was the only highly significant predictor (OR 16.956, CI 5.140–55.935,
p
< 0.001).
Conclusions
LRYCJ represents an attractive option for palliation of malignant distal biliary obstruction, with improved biliary-tract patency and less need for subsequent interventions such as additional stenting.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-022-02513-8</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Medicine ; Medicine & Public Health ; Original Article ; Surgery ; Surgical Oncology</subject><ispartof>Surgery today (Tokyo, Japan), 2022-11, Vol.52 (11), p.1568-1575</ispartof><rights>The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd. 2022</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-e9e173d1e8538b5c1f51ff8ea149268feaa915e218707d010668c314d8dca603</citedby><cites>FETCH-LOGICAL-c348t-e9e173d1e8538b5c1f51ff8ea149268feaa915e218707d010668c314d8dca603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-022-02513-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-022-02513-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27913,27914,41477,42546,51308</link.rule.ids></links><search><creatorcontrib>Kim, Eun Young</creatorcontrib><creatorcontrib>Lee, Soo Ho</creatorcontrib><creatorcontrib>Hong, Tae Ho</creatorcontrib><title>Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><description>Purposes
The advantages of surgical bypass for patients with distal biliary obstruction caused by advanced periampullary cancer include a low risk of recurrent biliary obstruction; however, the highly invasive nature of the operation limits its use. Herein, we present the clinical findings of patients who underwent laparoscopic Roux-en-Y choledochojejunostomy (LRYCJ) compared with those who underwent endoscopic stent insertion.
Methods
We reviewed, retrospectively, the palliative care outcomes for malignant bile duct obstruction according to the type of intervention: LRYCJ vs. endoscopic stenting. After initial intervention, the factors predisposing to recurrent biliary obstruction (RBO) were identified via multiple regression analysis.
Results
The final analysis included 28 patients treated with LRYCJ (22.4%) and 97 patients who underwent endoscopic stent insertion (77.6%). The two groups did not differ in the incidence of early or late complications and mortality; however, the LRYCJ group had a lower incidence of RBO (4 patients, 14.3% vs. 73 patients, 75.3%;
p
< 0.001). As a predisposing factor for RBO, endoscopic stenting was the only highly significant predictor (OR 16.956, CI 5.140–55.935,
p
< 0.001).
Conclusions
LRYCJ represents an attractive option for palliation of malignant distal biliary obstruction, with improved biliary-tract patency and less need for subsequent interventions such as additional stenting.</description><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kE9rHDEMxU1pIds0XyAnH3NxK9njWc-xhP6DQEvIJSfj9WhSL57xxPaU5pSvXqfbcw9CIN6Tnn6MXSK8R4D9hwKgBy1AylYalTCv2A471QtpUL1mOxg6FCgHPGNvSzkCyM4A7NjzDxdjcDX8Ih7d6nIqPq3B89u0_Ra0iHvuf6ZIY2rtSMdtSaWm-Ym7wh2fyJVwiMRrJldnWipPaw1p4VPKfHYxPCyuDcdQqov8ENqp_MTTodS8-RfhO_ZmcrHQxb9-zu4-f7q7_ipuvn_5dv3xRnjVmSpoINyrEcloZQ7a46Rxmgw57AbZm5bDDahJotnDfgSEvjdeYTea0bse1Dm7Oq1dc3rcqFQ7h-IpRrdQ2oqVfY-D7kHrJpUnqW8sSqbJrjnMLbZFsC-w7Qm2bbDtX9jWNJM6mUoTLw-U7TFteWkf_c_1B1n6hU8</recordid><startdate>20221101</startdate><enddate>20221101</enddate><creator>Kim, Eun Young</creator><creator>Lee, Soo Ho</creator><creator>Hong, Tae Ho</creator><general>Springer Nature Singapore</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20221101</creationdate><title>Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction</title><author>Kim, Eun Young ; Lee, Soo Ho ; Hong, Tae Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-e9e173d1e8538b5c1f51ff8ea149268feaa915e218707d010668c314d8dca603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Eun Young</creatorcontrib><creatorcontrib>Lee, Soo Ho</creatorcontrib><creatorcontrib>Hong, Tae Ho</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Eun Young</au><au>Lee, Soo Ho</au><au>Hong, Tae Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><date>2022-11-01</date><risdate>2022</risdate><volume>52</volume><issue>11</issue><spage>1568</spage><epage>1575</epage><pages>1568-1575</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purposes
The advantages of surgical bypass for patients with distal biliary obstruction caused by advanced periampullary cancer include a low risk of recurrent biliary obstruction; however, the highly invasive nature of the operation limits its use. Herein, we present the clinical findings of patients who underwent laparoscopic Roux-en-Y choledochojejunostomy (LRYCJ) compared with those who underwent endoscopic stent insertion.
Methods
We reviewed, retrospectively, the palliative care outcomes for malignant bile duct obstruction according to the type of intervention: LRYCJ vs. endoscopic stenting. After initial intervention, the factors predisposing to recurrent biliary obstruction (RBO) were identified via multiple regression analysis.
Results
The final analysis included 28 patients treated with LRYCJ (22.4%) and 97 patients who underwent endoscopic stent insertion (77.6%). The two groups did not differ in the incidence of early or late complications and mortality; however, the LRYCJ group had a lower incidence of RBO (4 patients, 14.3% vs. 73 patients, 75.3%;
p
< 0.001). As a predisposing factor for RBO, endoscopic stenting was the only highly significant predictor (OR 16.956, CI 5.140–55.935,
p
< 0.001).
Conclusions
LRYCJ represents an attractive option for palliation of malignant distal biliary obstruction, with improved biliary-tract patency and less need for subsequent interventions such as additional stenting.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><doi>10.1007/s00595-022-02513-8</doi><tpages>8</tpages></addata></record> |
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| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Medicine Medicine & Public Health Original Article Surgery Surgical Oncology |
| title | Palliative laparoscopic Roux-en-Y choledochojejunostomy as a feasible treatment option for malignant distal biliary obstruction |
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