Новости | Магазин | Журналы | Контакты | Правила | Доставка | |
Вход Регистрация |
Отношение к предоперационному билиарному дренированию (ПБД) при опухолевой механической желтухе за последнее время дважды менялось. Это обусловлено такими факторами, как осложнения минимально инвазивных методов ПБД, уровень блока желчных протоков, холангит, необходимость проведения неоадъювантной химиотерапии, срок до планируемой операции, тяжелое общее состояние больного, величина будущего остатка печени при планируемой резекции. В медицинских поисковых системах PubMed, MD Consult и National Library of Medicine изучили публикации по ключевым словам “механическая желтуха (МЖ)”, “клеточный иммунитет”, “предоперационное билиарное дренирование”, “селективное билиарное дренирование”, “дистальный и проксимальный блок желчных протоков”, “осложнения”. Ориентировались в основном на рандомизированные клинические исследования и метаанализы, мнения авторитетных специалистов в гепатопанкреатобилиарной хирургии, а также результаты собственных экспериментальных и клинических исследований. Анализ показал, что ПБД не является безопасной процедурой и его применение связано с увеличением числа осложнений. К абсолютным показаниям к ПБД следует отнести холангит, необходимость проведения неоадъювантной химиотерапии, повышенный риск радикальной операции и нерезектабельную опухоль. При уточнении показаний к ПБД при проксимальном блоке, вызванном воротной холангиокарциномой, следует ориентироваться на объем и функциональное состояние будущего остатка печени.
Ключевые слова:
печень, желчные протоки, механическая желтуха, миниинвазивные вмешательства, билиарное дренирование, холангит, холангиокарцинома, осложнения, резекция, liver, bile ducts, obstructive jaundice, minimally invasive interventions, biliary drainage, cholangitis, cholangiocarcinoma, complications, resection
Литература:
1.Wente M.N., Bassi C., Dervenis C., Gouma D.J., Izbicki J.R., Neoptolemos J.P., Padbury R.T., Sarr M.G., Traverso L.W., Yeo C.J., Buchler M.W. Delayed gastric emptying (DGE) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007; 142 (11): 761-768. http://doi.org/10.1016/j.surg.2007.05.005.
2.Wente M.N., Veit J.A., Bassi C., Dervenis Ch., Fingerhut A., Gouma D.J., Izbicki J.R., Neoptolemos J.P., Padbury R.T., Sarr M.G., Yeo Ch.J., Buchler M.W. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 2007; 142 (2): 20-25. http://doi.org/10.1016/j. surg.2007.02.001.
3.Gouma D.J., van Geenen R.C., van Gulik T.M., de Haan R.J., de Wit L.T., Busch O.R., Obertop H. Rates of complications and death after pancreaticoduodenectomy: risk factors and the impact of hospital volume. Ann. Surg. 2000; 232 (12): 786-795. http://doi.org/10.1097/00000658-200012000-00007.
4.Bassi С., Dervenis Ch., Butturini G., Fingerhut A., Yeo Ch., Izbicki J., Neoptolemos J., Sarr M., Traverso W., Buchler M. Postoperative pancreatic fistula: an International Study Group (ISGPF) definition. Surgery. 2005; 138 (5): 8-13. http://doi.org/10.1016/j.surg.2005.05.001.
5.Dindo D., Demartines N., Clavien P.A. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann. Surg. 2004; 240 (8): 205-213. http://doi.org/10.1097/01.sla.0000133083.54934.ae.
6.Sohn T.A., Yeo C.J., Cameron J.L., Geschwind J.F., Mitchell S.E., Venbrux A.C., Lillemoe K.D. Pancreaticoduodenectomy: role of interventional radiologists in managing patients and complications. J. Gastrointest. Surg. 2003; 7 (2): 209-219. http://doi.org/10.1016/ S1091-255X(02)00193-2.
7.Whipple A.O., Parsons W.B., Mullins C.R. Treatment of carcinoma of the ampulla of Vater. Ann. Surg. 1935; 102: 763-779. http://doi.org/10.1097/00000658-193510000-00023.
8.Glenn F., Evans J.A., Mujahed Z., Thorbjarnsarson B. Percutaneous transhepatic cholangiography. Ann. Surg. 1962; 156 (4): 451-462. http://doi.org/10.1097/00000658-196209000-00012.
9.Greve J.W., Gouma D.J., Buurman W.A. Complications in obstructive jaundice: role of endotoxins. Scand. J. Gastroenterol. Suppl. 1992; 194 (7): 8-12. http://doi.org/10.3109/00365529209096019.
10.Clements W.D., Erwin P., McCaigue M.D., Halliday I., Barclay G.R., Rowlands B.J. Conclusive evidence of endotoxaemia in biliary obstruction. Gut. 1998; 42 (2): 293-299.
11.Kimmings A.N., van Deventer S.J., Obertop H., Rauws E.A., Gouma D.J. Inflammatory and immunologic effects of obstructive jaundice: pathogenesis and treatment. J. Am. Coll. Surg. 1995; 181 (12): 567-581.
12.Parks R.W., Clements W.D., Smye M.G., Pope C., Rowlands B.J., Diamond T. Intestinal barrier dysfunction in clinical and experimental obstructive jaundice and its reversal by internal biliary drainage. Br. J. Surg. 1996; 83 (10): 1345-1349. http://doi.org/10.1002/bjs.1800831007.
13.Clements W.D., McCaigue M., Erwin P., Halliday I., Rowlands B.J. Biliary decompression promotes Kupffer cell recovery in obstructive jaundice. Gut. 1996; 38 (6): 925-931. http://doi.org/10.1136/gut.38.6.925.
14.Tanaka N., Ryden S., Bergqvist L., Christensen P., Bengmark S. Reticulo-endothelial function in rats with obstructive jaundice. Br. J. Surg. 1985; 72 (12): 946-949. http://doi.org/10.1002/bjs.1800721204.
15.Minter R.M., Fan M.H., Sun J., Niederbichler A., Ipaktchi K., Arbabi S., Hemmila M.R., Remick D.G., Wang S.C., Su G.L. Altered Kupffer cell function in biliary obstruction. Surgery. 2005; 138 (8): 236-245. http://doi.org/10.1016/j. surg.2005.04.001.
16.Kennedy J.A., Clements W.D., Kirk S.J., McCaigue M.D., Campbell G.R., Erwin P.J., Halliday M.I., Rowlands B.J. Characterization of the Kupffer cell response to exogenous endotoxin in a rodent model of obstructive jaundice. Br. J. Surg. 1999; 86 (12): 628-633. http://doi.org/10.1046/ j.1365-2168.1999.01114.x.
17.Nehez L., Andersson R. Compromise of immune function in obstructive jaundice. Eur. J. Surg. 2002; 168 (6): 315-328. http://doi.org/10.1080/ 11024150260284815.
18.Ohtsuka M., Miyazaki M., Kondo Y., Nakajima N. Neutrophilmediated sinusoidal endothelial cell injury after extensive hepatectomy in cholestatic rats. Hepatology. 1997; 25 (3): 636-641. http://doi.org/10.1002/hep.510250324.
19.Bemelmans M.H., Gouma D.J., Greve J.W., Buurman W.A. Cytokines tumor necrosis factor and interleukin-6 in experimental biliary obstruction in mice. Hepatology. 1992; 15 (6): 1132-1136. http://doi.org/10.1002/ hep.1840150626.
20.Abe T., Arai T., Ogawa A., Hiromatsu T., Masuda A., Matsuguchi T., Nimura Y., Yoshikai Y. Kupffer cell-derived interleukin 10 is responsible for impaired bacterial clearance in bile duct-ligated mice. Hepatology. 2004; 40 (8): 414-423. http://doi.org/10.1002/hep.20301.
21.Sewnath M.E., van der Poll T., van Noorden C.J.F., ten Kate F.J.W., Gouma D.J. Cholestatic interleukin-6-deficient mice succumb to endotoxin-induced liver injury and pulmonary inflammation. Am. J. Respir. Crit. Care Med. 2004; 169 (3): 413-420. http://doi.org/10.1164/rccm.200303-311OC.
22.Bemelmans M.H., Greve J.W., Gouma D.J., Buurman W.A. Increased concentrations of tumour necrosis factor (TNF) and soluble TNF receptors in biliary obstruction in mice; soluble TNF receptors as prognostic factors for mortality. Gut. 1996; 38 (3): 447-453. http://doi.org/10.1136/ gut.38.3.447.
23.Ахаладзе Г.Г. Патогенетические аспекты гнойного холангита, почему нет системной воспалительной реакции при механической желтухе? Анналы хирургической гепатологии. 2009; 14 (2): 9-15.
24.Gehring S., Dickson E.M., San Martin M.E., van Rooijen N., Papa E.F., Harty M.W., Tracy T.F. Jr., Gregory S.H. Kupffer cells abrogate cholestatic liver injury in mice. Gastroenterology. 2006; 130 (3): 810-822. http://doi.org/10.1053/j.gastro.2005.11.015.
25.Kimmings A.N., van Deventer S.J., Obertop H., Rauwsc E.A.J., Huibregtsec K., Gouma D.J. Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage. Gut. 2000; 46 (5): 725-731. http://doi.org/10.1136/gut.46.5.725.
26.Greve J.W., Gouma D.J., Soeters P.B., Buurman W.A. Suppression of cellular immunity in obstructive jaundice is caused by endotoxins: a study with germ-free rats. Gastroenterology. 1990; 98 (2): 478-485.
27.Hirazawa K., Hazama S., Oka M. Depressed cytotoxic activity of hepatic nonparenchymal cells in rats with obstructive jaundice. Surgery. 1999; 126 (5): 900-907.
28.Lane D.R., Joshi P., Grogan J.B., Nie C.H., Scott-Conner C.E. Suppression of natural killer cell activity in biliary obstruction. Am. Surg. 1996; 62 (4): 259-262.
29.Wait R.B., Kahng K.U. Renal failure complicating obstructive jaundice. Am. J. Surg. 1989; 157 (2): 256-263. http://doi.org/10.1016/0002-9610 (89)90540-0.
30.Padillo F.J., Cruz A., Briceno J., Martin-Malo A., Pera-Madrazo C., Sitges-Serra A. Multivariate analysis of factors associated with renal dysfunction in patients with obstructive jaundice. Br. J. Surg. 2005; 92 (11): 1388-1392. http://doi.org/10.1002/bjs.5091.
31.Martinez-Rodenas F., Pereira J.A., Jimenez W., Gubern J.M., Sitges-Serra A. Circulating bile is the main factor responsible for atrial natriuretic peptide release in experimental obstructive jaundice. Br. J. Surg. 1998; 85 (4): 480-484. http://doi.org/10.1046/j.1365-2168.1998.00661.x.
32.Padillo F.J., Briceno J., Cruz A., Chicano M., Naranjo A., Vallejo J., Martin-Malo A., Pera-Madrazo C., Sitges-Serra A. Randomized clinical trial of the effect of intravenous fluid administration on hormonal and renal dysfunction in patients with obstructive jaundice undergoing endoscopic drainage. Br. J. Surg. 2005; 92 (1): 39-43. http://doi.org/10.1002/bjs.4790.
33.Padillo J., Puente J., Gomez M., Dios F., Naranjo A., Vallejo J.A., Mino G., Pera C., Sitges-Serra A. Improved cardiac function in patients with obstructive jaundice after internal biliary drainage: hemodynamic and hormonal assessment. Ann. Surg. 2001; 234 (11): 652-656. http://doi.org/10.1097/00000658-200111000-00010.
34.Gouma D.J., Coelho J.C., Fisher J.D., Schlegel J.F., Li Y.F., Moody F.G. Endotoxemia after relief of biliary obstruction by internal and external drainage in rats. Am. J. Surg. 1986; 151 (4): 476-479. http://doi.org/10.1016/0002-9610(86)90107-8.
35.Roughneen P.T., Gouma D.J., Kulkarni A.D., Fanslow W.F., Rowlands B.J. Impaired specific cell-mediated immunity in experimental biliary obstruction and its reversibility by internal biliary drainage. J. Surg. Res. 1986; 41 (8): 113-125. http://doi.org/10.1016/0022-4804(86)90016-8.
36.Gouma D.J., Roughneen P.T., Kumar S., Moody F.G., Rowlands B.J. Changes in nutritional status associated with obstructive jaundice and biliary drainage in rats. Am. J. Clin. Nutr. 1986; 44 (9): 362-369.
37.Bemelmans M.H., Gouma D.J., Greve J.W., Buurman W.A. Effect of antitumour necrosis factor treatment on circulating tumour necrosis factor levels and mortality after surgery in jaundiced mice. Br. J. Surg. 1993; 80 (8): 1055-1058. http://doi.org/10.1002/bjs.1800800845.
38.Megison S.M., Dunn C.W., Horton J.W., Chao H. Effects of relief of biliary obstruction on mononuclear phagocyte system function and cell mediated immunity. Br. J. Surg. 1991; 78 (5): 568-571. http://doi.org/10.1002/bjs.1800780516.
39.Гальперин Э.И., Татишвили Г.Г., Ахаладзе Г.Г., Сакеварашвили Г.Р. Нарушения органной гемодинамики печени и их коррекция при гнойном холангите. Хирургия. 1991; 9: 77-81.
40.Gouma D.J., Coelho J.C., Schlegel J.F., Li Y.F., Moody F.G. The effect of preoperative internal and external biliary drainage on mortality of jaundiced rats. Arch. Surg. 1987; 122 (6): 731-734.
41.Mizuguchi K., Ajiki T., Onoyama H., Tomita M., Kuroda Y. Short-term effects of external and internal biliary drainage on liver and cellular immunity in experimental obstructive jaundice. J. Hepatobiliary Pancreat. Surg. 2004; 11 (3): 176-180. http://doi.org/10.1007/s00534-003-0886-z.
42.Saiki S., Chijiiwa K., Komura M., Komura M., Yamaguchi K., Kuroki S., Tanaka M. Preoperative internal biliary drainage is superior to external biliary drainage in liver regeneration and function after hepatectomy in obstructive jaundiced rats. Ann. Surg. 1999; 230 (5): 655-662. http://doi.org/10.1097/00000658-199911000-00007.
43.Karsten T.M., Davids P.H., van Gulik T.M., Bosma A., Tytgat G.N., Klopper P.J., van der Hyde M.N. Effects of biliary endoprostheses on the extrahepatic bile ducts in relation to subsequent operation of the biliary tract. J. Am. Coll. Surg. 1994; 178 (4): 343-352.
44.Koyama K., Takagi Y., Ito K., Sato T. Experimental and clinical studies on the effect of biliary drainage in obstructive jaundice. Am. J. Surg. 1981; 142 (8): 293-299. http://doi.org/10.1016/0002-9610(81)90296-8.
45.Kawarada Y., Higashiguchi T., Yokoi H., Vaidya P., Mizumoto R. Preoperative biliary drainage in obstructive jaundice. Hepatogastroenterology. 1995; 42 (7): 300-307.
46.Платонова Л.В., Шоно Н.И., Ахаладзе Г.Г., Гальпе рин Э.И. Энергетический статус ткани печени при механической желтухе (экспериментальное исследование). Анналы хирургической гепатологии. 2002; 7 (2): 45-50.
47.Маады А.С., Карпов О.Э., Стойко Ю.М., Ветшев П.С., Бруслик С.В., Левчук А.Л. Эндоскопическое билиарное стентирование при опухолевой механической желтухе. Анналы хирургической гепатологии. 2015; 20 (3): 59-67.
48.Pitt H.A., Gomes A.S., Lois J.F., Mann L.L., Deutsch L.S., Longmire W.P. Jr. Does preoperative percutaneous biliary drainage reduce operative risk or increase hospital cost? Ann. Surg. 1985; 201 (5): 545-553. http://doi.org/10.1097/00000658-198505000-00002.
49.Sewnath M.E., Karsten T.M., Prins M.H., Rauws E.J., Obertop H., Gouma D.J. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Ann. Surg. 2002; 236 (7): 17-27. http://doi.org/10.1097/ 00000658-200207000-00005.
50.van der Gaag N.A., Kloek J.J., de Castro S.M., Busch O.R., van Gulik T.M., Gouma D.J. Preoperative biliary drainage in patients with obstructive jaundice: history and current status. J. Gastrointest. Surg. 2009; 13 (4): 814-820. http://doi.org/10.1007/s11605-008-0618-4.
51.Lassen K., Coolsen M.M., Slim K., Carli F., de Aguilar-Nascimento J.E., Schafer M., Parks R.W., Fearon K.C., Lobo D.N., Demartines N., Braga M., Ljungqvist O., Dejong C.H. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. World J. Surg. 2013; 37 (2): 240-258.
52.Bakens M., van Rijssen B., van Woerden V., Besselink M., Boerma D., Busch O., Dejong K., Gerhards M., van Hooft J., Keulemans Y., Klaase J., Luyer M., Molenaar Q., Oor J., Schoon E., Steen W., Tseng D., Gouma D.J., de Hingh I. Evaluation of preoperative biliary drainage in patients undergoing pancreatoduodenectomy for suspected pancreatic or periampullary cancer. JOP. 2018; 19 (1).
53.Pisters P.W., Lee J.E., Vauthey J.N., Evans D.B. Comment and perspective on Sewnath and colleagues’ recent meta-analysis of the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice. Ann. Surg. 2003; 237 (4): 594-595.
54.Moole H., Bechtold M., Puli S.R. Efficacy of preoperative biliary drainage in malignant obstructive jaundice: a metaanalysis and systematic review. World J. Surg. Oncol. 2016; 14 (7): 182. http://doi.org/10.1186/s12957-016-0933-2.
55.Sandini M., Honselmann K.C., Birnbaum D.J., Gavazzi F., Chirica M., Wellner U., Guilbaud T., Bolm L., Angrisani M., Moutardier V., Cereda M., Girard E., Montorsi M., Keck T., Zerbi A., Gianotti L. Preoperative biliary stenting and major morbidity after pancreatoduodenectomy: does elapsed time matter? The FRAGERITA Study Group. Ann. Surg. 2018; 268 (5): 808-814. http://doi.org/10.1097/SLA.0000000000002838.
56.Гальперин Э.И., Момунова О.Н. Классификация тяжести механической желтухи. Хирургия. 2014; 1: 5-9.
57.Гальперин Э.И., Котовский А.Е., Момунова О.Н. Темп декомпрессии желчных протоков при механической желтухе опухолевой этиологии. Хирургия. 2011; 8: 33-40.
58.Scheufele F., Aichinger L., Jager C., Demir I.E., Schorn S., Sargut M., Erkan M., Kleeff J., Friess H., Ceyhan G.O. Effect of preoperative biliary drainage on bacterial flora in bile of patients with periampullary cancer. Br. J. Surg. 2017; 104 (1): e182-e188.
59.Lazaridis K.N., Gores G.J. Cholangiocarcinoma. Gastroenterology. 2005; 128 (5): 1655-1667. http://doi.org/10.1053/j.gastro.2005.03.040.
60.Clavien P.A., Emond J., Vauthey J.N., Belghiti J., Chari R.S., Strasberg S.M. Protection of the liver during hepatic surgery. J. Gastrointest. Surg. 2004; 8 (3-4): 313-327. http://doi.org/10.1016/j.gassur.2003.12.006.
61.Clavien P.A., Petrowsky H., De Oliveira M.L., Graf R. Strategies for safer liver surgery and partial liver transplantation. N. Engl. J. Med. 2007; 356 (4): 1545-1559. http://doi.org/10.1056/NEJMra065156.
62.Blamey S.L., Fearon K.C., Gilmour W.H., Osborne D.H., Carter D.C. Prediction of risk in biliary surgery. Br. J. Surg. 1983; 70 (9): 535-538. http://doi.org/10.1002/ bjs.1800700910.
63.Dixon J.M., Armstrong C.P., Duffy S.W., Davies G.C. Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. Gut. 1983; 24 (9): 845-852. http://doi.org/10.1136/gut.24.9.845.
64.Shigeta H., Nagino M., Kamiya J., Katsuhiko K., Tsuyoshi U., Hideo S., Naokazu Y., Michio H., Nimura Y. Bacteremia after hepatectomy: an analysis of a single-center, 10-year experience with 407 patients. Langenbecks Arch. Surg. 2002; 387 (7): 117-124. http://doi.org/10.1007/s00423-002-0301-2.
65.Шевченко Ю.Л., Ветшев П.С., Стойко Ю.М., Левчук А.Л., Бардаков В.Г., Степанюк И.В. Диагностика и хирургическая тактика при синдроме механической желтухи. Анналы хирургической гепатологии. 2008; 13 (4): 96-105.
66.van der Gaag N.A., de Castro S.M., Rauws E.A., Bruno M.J., van Eijck C.H., Kuipers E.J., Gerritsen J.J., Rutten J.P., Greve J.W., Hesselink E.J., Klinkenbijl J.H., Rinkes I.H., Boerma D., Bonsing B.A., van Laarhoven C.J., Kubben F.J., van der Harst E., Sosef M.N., Bosscha K., de Hingh I.H., Th de Wit L., van Delden O.M., Busch O.R., van Gulik T.M., Bossuyt P.M., Gouma D.J. Preoperative biliary drainage for periampullary tumors causing obstructive jaundice; Drainage vs. (direct) Operation (DROP-trial). BMC Surg. 2007; 7 (3): 3. http://doi.org/10.1186/1471-2482-7-3.
67.Suzuki H., Iyomasa S., Nimura Y., Yoshida S. Internal biliary drainage, unlike external drainage, does not suppress the regeneration of cholestatic rat liver after partial hepatectomy. Hepatology. 1994; 20 (11): 1318-1322.
68.Saiki S., Chijiiwa K., Komura M., Saiki S., Chijiiwa K., Komura M., Yamaguchi K., Kuroki S., Tanaka M. Preoperative internal biliary drainage is superior to external biliary drainage in liver regeneration and function after hepatectomy in obstructive jaundiced rats. Ann. Surg. 1999; 230 (11): 655-662. http://doi.org/10.1097/00000658-199911000-00007.
69.Hatfield A.R., Tobias R., Terblanche J., Fataar S., Kernoff L., Tobias R., Girdwood A.H., Harries-Jones R., Marks I.N. Preoperative external biliary drainage in obstructive jaundice. A prospective controlled clinical trial. Lancet. 1982; 2 (10): 896-899. http://doi.org/10.1016/S0140-6736 (82)90866-2.
70.McPherson G.A., Benjamin I.S., Hodgson H.J., Bowley N.B., Allison D.J., Blumgart L.H. Pre-operative percutaneous transhepatic biliary drainage: the results of a controlled trial. Br. J. Surg. 1984; 71 (5): 371-375. http://doi.org/10.1002/ bjs.1800710522.
71.Nimura Y., Kamiya J., Kondo S., Nagino M., Uesaka K., Oda K., Sano T., Yamamoto H., Hayakawa N. Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoya experience. J. Hepatobiliary Pancreat. Surg. 2000; 7 (2): 155-162. http://doi.org/10.1007/s005340050170.
72.Seyama Y., Kubota K., Sano K. Long-term outcome of extended hemihepatectomy for hilar bile duct cancer with no mortality and high survival rate. Ann. Surg. 2003; 238 (1): 73-83. http://doi.org/10.1097/00000658-200307000-00010.
73.Kawasaki S., Imamura H., Kobayashi A., Noike T., Miwa S., Miyagawa S. Results of surgical resection for patients with hilar bile duct cancer: application of extended hepatectomy after biliary drainage and hemihepatic portal vein embolization. Ann. Surg. 2003; 238 (7): 84-92. http://doi.org/10.1097/00000658-200307000-00011.
74.Kosuge T., Yamamoto J., Shimada K., Yamasaki S., Makuuchi M. Improved surgical results for hilar cholangiocarcinoma with procedures including major hepatic resection. Ann. Surg. 1999; 230 (11): 663-671. http://doi.org/10.1097/00000658-199911000-00008.
75.Nagino M., Kamiya J., Nishio H., Ebata T., Arai T., Nimura Y. Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann. Surg. 2006; 243 (3): 364-372. http://doi.org/10.1097/01.sla.0000201482.11876.14.
76.Belghiti J., Ogata S. Preoperative optimization of the liver for resection in patients with hilar cholangiocarcinoma. HPB. 2005; 7 (4): 252-253.
77.Maguchi H., Takahashi K., Katanuma A., Kazuyuki O., Shinpei N., Urata T., Iwano H. Preoperative biliary drainage for hilar cholangiocarcinoma. J. Hepatobiliary Pancreat. Surg. 2007; 14 (9): 441-446. http://doi.org/10.1007/s00534-006-1192-3.
78.Miyagawa S., Makuuchi M., Kawasaki S. Outcome of extended right hepatectomy after biliary drainage in hilar bile duct cancer. Arch. Surg. 1995; 130 (7): 759-763.
79.Hadjis N.S., Adam A., Gibson R., Blenkharn J., Benjamin I.S., Blumgart L.H. Nonoperative approach to hilar cancer deter mi ned by the atrophy-hypertrophy complex. Am. J. Surg. 1989; 157 (4): 395-399. http://doi.org/10.1016/0002-9610(89)90583-7.
80.Ishizawa T., Hasegawa K., Sano K., Imamura H., Kokudo N., Makuuchi M. Selective versus total biliary d
Attitude towards preoperative biliary drainage for malignant obstructive jaundice have recently changed twice. This is due certain factors including complications of minimally invasive biliary drainage, level of bile duct block, cholangitis, need for neoadjuvant chemotherapy, time to scheduled surgery, severe general condition of patient, future liver remnant volume. We comprehensively searched PUBMED, MD Consult and National Library of Medicine using the following keywords: “obstructive jaundice (OJ)”, “cellular immunity”, “preoperative biliary drainage”, “selective biliary drainage”, “distal and proximal bile duct block”, “complications”. Randomized clinical trials and meta-analyzes, opinions of reputable specialists in hepatopancreatobiliary surgery and our own experimental and clinical studies were foreground. The analysis showed that preoperative biliary drainage is not a safe procedure and results an increased number of complications. Absolute indications for preoperative biliary drainage are cholangitis, need for neoadjuvant chemotherapy, increased risk of radical surgery and unresectable tumor. Future liver remnant volume should be considered in patients with portal cholangiocarcinoma followed by proximal block to determine indications for preoperative biliary drainage.
Keywords:
печень, желчные протоки, механическая желтуха, миниинвазивные вмешательства, билиарное дренирование, холангит, холангиокарцинома, осложнения, резекция, liver, bile ducts, obstructive jaundice, minimally invasive interventions, biliary drainage, cholangitis, cholangiocarcinoma, complications, resection