Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

Anouk E. J. Latenstein; Tara M. Mackay; Nadine C. M. van Huijgevoort; Bert A. Bonsing; Koop Bosscha; Lieke Hol; Marco J. Bruno; Marielle M. E. van Coolsen; Sebastiaan Festen; Erwin van Geenen; Bas Groot Koerkamp; Gerrit J. M. Hemmink; Ignace H. J. T. de Hingh; Geert Kazemier; Hans Lubbinge; Vincent E. de Meijer; I. Quintus Molenaar; Rutger Quispel; Hjalmar C. van Santvoort; Tom C. J. Seerden; Martijn W. J. Stommel; Niels G. Venneman; Robert C. Verdonk; Marc G. Besselink; Jeanin E. van Hooft

doi:10.1016/j.hpb.2020.06.009

Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

Anouk E. J. Latenstein^*, Tara M. Mackay, Nadine C. M. van Huijgevoort, Bert A. Bonsing, Koop Bosscha, Lieke Hol, Marco J. Bruno, Marielle M. E. van Coolsen, Sebastiaan Festen, Erwin van Geenen, Bas Groot Koerkamp, Gerrit J. M. Hemmink, Ignace H. J. T. de Hingh, Geert Kazemier, Hans Lubbinge, Vincent E. de Meijer, I. Quintus Molenaar, Rutger Quispel, Hjalmar C. van Santvoort, Tom C. J. SeerdenMartijn W. J. Stommel, Niels G. Venneman, Robert C. Verdonk, Marc G. Besselink, Jeanin E. van Hooft^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes.Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Multi variable logistic and linear regression models were performed.Results: In total, 575/1056 patients (62.0%) underwent preoperative EBD: 246 SEMS (42.8%) and 329 plastic stents (57.2%). EBD-related complications were comparable between the groups (44/246 (17.9%) vs. 64/329 (19.5%), p = 0.607), including pancreatitis (22/246 (8.9%) vs. 25/329 (7.6%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1%) vs. 32/329 (9.7%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6%) vs. 90/329 (27.4%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8%) vs. 61/329 (18.5%), p = 0.004; OR 0.50 95%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95%CI -5.16 to -0.57, p = 0.014) were less after SEMS placement.Conclusion: This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.

Original language	English
Pages (from-to)	270-278
Number of pages	9
Journal	HPB
Volume	23
Issue number	2
Early online date	Feb 2021
DOIs	https://doi.org/10.1016/j.hpb.2020.06.009
Publication status	Published - Feb 2021

Bibliographical note

Funding Information:
The Dutch Pancreatic Cancer Project, including the Dutch Pancreatic Cancer Audit, received funding from the Dutch Cancer Society (KWF Kankerbestrijding; grant no. UVA2013-5842 ).

Publisher Copyright:
© 2020 The Author(s)

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Latenstein, A. E. J., Mackay, T. M., van Huijgevoort, N. C. M., Bonsing, B. A., Bosscha, K., Hol, L., Bruno, M. J., van Coolsen, M. M. E., Festen, S., van Geenen, E., Koerkamp, B. G., Hemmink, G. J. M., de Hingh, I. H. J. T., Kazemier, G., Lubbinge, H., de Meijer, V. E., Molenaar, I. Q., Quispel, R., van Santvoort, H. C., ... van Hooft, J. E. (2021). Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer. HPB, 23(2), 270-278. https://doi.org/10.1016/j.hpb.2020.06.009

@article{e538b1fa5a644d5fa4167aa8ba58a61e,

title = "Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer",

abstract = "Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes.Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Multi variable logistic and linear regression models were performed.Results: In total, 575/1056 patients (62.0\%) underwent preoperative EBD: 246 SEMS (42.8\%) and 329 plastic stents (57.2\%). EBD-related complications were comparable between the groups (44/246 (17.9\%) vs. 64/329 (19.5\%), p = 0.607), including pancreatitis (22/246 (8.9\%) vs. 25/329 (7.6\%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1\%) vs. 32/329 (9.7\%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95\%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6\%) vs. 90/329 (27.4\%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8\%) vs. 61/329 (18.5\%), p = 0.004; OR 0.50 95\%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95\%CI -5.16 to -0.57, p = 0.014) were less after SEMS placement.Conclusion: This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.",

author = "Latenstein, \{Anouk E. J.\} and Mackay, \{Tara M.\} and \{van Huijgevoort\}, \{Nadine C. M.\} and Bonsing, \{Bert A.\} and Koop Bosscha and Lieke Hol and Bruno, \{Marco J.\} and \{van Coolsen\}, \{Marielle M. E.\} and Sebastiaan Festen and \{van Geenen\}, Erwin and Koerkamp, \{Bas Groot\} and Hemmink, \{Gerrit J. M.\} and \{de Hingh\}, \{Ignace H. J. T.\} and Geert Kazemier and Hans Lubbinge and \{de Meijer\}, \{Vincent E.\} and Molenaar, \{I. Quintus\} and Rutger Quispel and \{van Santvoort\}, \{Hjalmar C.\} and Seerden, \{Tom C. J.\} and Stommel, \{Martijn W. J.\} and Venneman, \{Niels G.\} and Verdonk, \{Robert C.\} and Besselink, \{Marc G.\} and \{van Hooft\}, \{Jeanin E.\}",

note = "Funding Information: The Dutch Pancreatic Cancer Project, including the Dutch Pancreatic Cancer Audit, received funding from the Dutch Cancer Society (KWF Kankerbestrijding; grant no. UVA2013-5842 ). Publisher Copyright: {\textcopyright} 2020 The Author(s)",

year = "2021",

month = feb,

doi = "10.1016/j.hpb.2020.06.009",

language = "English",

volume = "23",

pages = "270--278",

journal = "HPB",

issn = "1365-182X",

publisher = "Elsevier",

number = "2",

}

Latenstein, AEJ, Mackay, TM, van Huijgevoort, NCM, Bonsing, BA, Bosscha, K, Hol, L , Bruno, MJ, van Coolsen, MME, Festen, S, van Geenen, E, Koerkamp, BG, Hemmink, GJM, de Hingh, IHJT, Kazemier, G, Lubbinge, H, de Meijer, VE, Molenaar, IQ, Quispel, R, van Santvoort, HC, Seerden, TCJ, Stommel, MWJ, Venneman, NG, Verdonk, RC, Besselink, MG & van Hooft, JE 2021, 'Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer', HPB, vol. 23, no. 2, pp. 270-278. https://doi.org/10.1016/j.hpb.2020.06.009

TY - JOUR

T1 - Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

AU - Latenstein, Anouk E. J.

AU - Mackay, Tara M.

AU - van Huijgevoort, Nadine C. M.

AU - Bonsing, Bert A.

AU - Bosscha, Koop

AU - Hol, Lieke

AU - Bruno, Marco J.

AU - van Coolsen, Marielle M. E.

AU - Festen, Sebastiaan

AU - van Geenen, Erwin

AU - Koerkamp, Bas Groot

AU - Hemmink, Gerrit J. M.

AU - de Hingh, Ignace H. J. T.

AU - Kazemier, Geert

AU - Lubbinge, Hans

AU - de Meijer, Vincent E.

AU - Molenaar, I. Quintus

AU - Quispel, Rutger

AU - van Santvoort, Hjalmar C.

AU - Seerden, Tom C. J.

AU - Stommel, Martijn W. J.

AU - Venneman, Niels G.

AU - Verdonk, Robert C.

AU - Besselink, Marc G.

AU - van Hooft, Jeanin E.

N1 - Funding Information: The Dutch Pancreatic Cancer Project, including the Dutch Pancreatic Cancer Audit, received funding from the Dutch Cancer Society (KWF Kankerbestrijding; grant no. UVA2013-5842 ). Publisher Copyright: © 2020 The Author(s)

PY - 2021/2

Y1 - 2021/2

N2 - Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes.Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Multi variable logistic and linear regression models were performed.Results: In total, 575/1056 patients (62.0%) underwent preoperative EBD: 246 SEMS (42.8%) and 329 plastic stents (57.2%). EBD-related complications were comparable between the groups (44/246 (17.9%) vs. 64/329 (19.5%), p = 0.607), including pancreatitis (22/246 (8.9%) vs. 25/329 (7.6%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1%) vs. 32/329 (9.7%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6%) vs. 90/329 (27.4%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8%) vs. 61/329 (18.5%), p = 0.004; OR 0.50 95%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95%CI -5.16 to -0.57, p = 0.014) were less after SEMS placement.Conclusion: This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.

AB - Background: Guidelines advise self-expanding metal stents (SEMS) over plastic stents in preoperative endoscopic biliary drainage (EBD) for malignant extrahepatic biliary obstruction. This study aims to assess nationwide practice and outcomes.Methods: Patients with pancreatic head and periampullary cancer who underwent EBD before pancreatoduodenectomy were included from the Dutch Pancreatic Cancer Audit (2017-2018). Multi variable logistic and linear regression models were performed.Results: In total, 575/1056 patients (62.0%) underwent preoperative EBD: 246 SEMS (42.8%) and 329 plastic stents (57.2%). EBD-related complications were comparable between the groups (44/246 (17.9%) vs. 64/329 (19.5%), p = 0.607), including pancreatitis (22/246 (8.9%) vs. 25/329 (7.6%), p = 0.387). EBD-related cholangitis was reduced after SEMS placement (10/246 (4.1%) vs. 32/329 (9.7%), p = 0.043), which was confirmed in multivariable analysis (OR 0.36 95%CI 0.15-0.87, p = 0.023). Major postoperative complications did not differ (58/246 (23.6%) vs. 90/329 (27.4%), p = 0.316), whereas postoperative pancreatic fistula (24/246 (9.8%) vs. 61/329 (18.5%), p = 0.004; OR 0.50 95%CI 0.27-0.94, p = 0.031) and hospital stay (14.0 days vs. 17.4 days, p = 0.005; B 2.86 95%CI -5.16 to -0.57, p = 0.014) were less after SEMS placement.Conclusion: This study found that preoperative EBD frequently involved plastic stents. SEMS seemed associated with lower risks of cholangitis and less postoperative pancreatic fistula, but without an increased pancreatitis risk.

UR - https://www.scopus.com/pages/publications/85087981080

U2 - 10.1016/j.hpb.2020.06.009

DO - 10.1016/j.hpb.2020.06.009

M3 - Article

C2 - 32682665

SN - 1365-182X

VL - 23

SP - 270

EP - 278

JO - HPB

JF - HPB

IS - 2

ER -

Nationwide practice and outcomes of endoscopic biliary drainage in resectable pancreatic head and periampullary cancer

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