Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?

Pankaj Gupta; Varun Bansal; Naveen Kalra; Jayanta Samanta; Harshal Mandavdhare; Vishal Sharma; Usha Dutta; Rakesh Kochhar; Manavjit Singh Sandhu

doi:10.5114/ceh.2021.104674

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?

Pankaj Gupta

¹

,

Varun Bansal

¹

,

Naveen Kalra

¹

,

Jayanta Samanta

²

,

Harshal Mandavdhare

²

,

Vishal Sharma

²

,

Usha Dutta

²

,

Rakesh Kochhar

²

,

Manavjit Singh Sandhu

¹

Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Clin Exp HEPATOL 2021; 7, 1: 7-12

DOI: https://doi.org/10.5114/ceh.2021.104674

Online publish date: 2021/03/25

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AMA

Gupta P, Bansal V, Kalra N, et al. Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?. Clinical and Experimental Hepatology. 2021;7(1):7-12. doi:10.5114/ceh.2021.104674.

APA

Gupta, P., Bansal, V., Kalra, N., Samanta, J., Mandavdhare, H.,  & Sharma, V. et al. (2021). Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?. Clinical and Experimental Hepatology, 7(1), 7-12. https://doi.org/10.5114/ceh.2021.104674

Chicago

Gupta, Pankaj, Varun Bansal, Naveen Kalra, Jayanta Samanta, Harshal Mandavdhare, Vishal Sharma,  and Usha Dutta et al. 2021. "Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?". Clinical and Experimental Hepatology 7 (1): 7-12. doi:10.5114/ceh.2021.104674.

Harvard

Gupta, P., Bansal, V., Kalra, N., Samanta, J., Mandavdhare, H., Sharma, V., Dutta, U., Kochhar, R.,  and Singh Sandhu, M. (2021). Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?. Clinical and Experimental Hepatology, 7(1), pp.7-12. https://doi.org/10.5114/ceh.2021.104674

MLA

Gupta, Pankaj et al. "Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?." Clinical and Experimental Hepatology, vol. 7, no. 1, 2021, pp. 7-12. doi:10.5114/ceh.2021.104674.

Vancouver

Gupta P, Bansal V, Kalra N, Samanta J, Mandavdhare H, Sharma V et al. Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?. Clinical and Experimental Hepatology. 2021;7(1):7-12. doi:10.5114/ceh.2021.104674.

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Aim of the study
This study aimed to evaluate the outcomes of patients with unresectable gallbladder cancer (GBC) with hilar involvement and cholangitis undergoing percutaneous transhepatic biliary drainage (PTBD).

Material and methods
This retrospective study comprised consecutive patients with unresectable GBC with cholangitis who underwent PTBD. The procedures were categorized as unilateral or bilateral. Bilateral PTBD was classified as simultaneous or sequential. The mean reduction in bilirubin at two weeks was recorded. Complications and mean overall survival were also recorded.

Results
Thirty-three patients (mean age 54.5 years, 12 males) were included. Thirty patients underwent unilateral drainage. Sequential drainage of the contralateral system was performed in 11 patients. Simultaneous bilateral PTBD was performed in 3 patients. PTBD was technically successful in all patients. Mean reduction in bilirubin was 41.5% in the unilateral group. The fall of bilirubin in the simultaneous bilateral PTBD group was 39%. The mean follow-up duration was 36.5 days. No major complications were encountered. At the last follow-up, 7 patients were alive. The mean overall survival was 34.6 days.

Conclusions
Patients with unresectable GBC and cholangitis frequently require bilateral drainage. However, prospective studies should be performed to evaluate whether a sequential or simultaneous PTBD should be performed.

keywords:

Should patients with unresectable gallbladder cancer with hilar involvement undergo unilateral or bilateral percutaneous biliary drainage in the setting of cholangitis?

Pankaj Gupta 1 , Varun Bansal 1 , Naveen Kalra 1 , Jayanta Samanta 2 , Harshal Mandavdhare 2 , Vishal Sharma 2 , Usha Dutta 2 , Rakesh Kochhar 2 , Manavjit Singh Sandhu 1

gallbladder cancer, biliary drainage, PTBD, cholangitis

Pankaj Gupta

¹

,

Varun Bansal

¹

,

Naveen Kalra

¹

,

Jayanta Samanta

²

,

Harshal Mandavdhare

²

,

Vishal Sharma

²

,

Usha Dutta

²

,

Rakesh Kochhar

²

,

Manavjit Singh Sandhu

¹