AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their surviv...AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. METHODS: Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after drainage.RESULTS: Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not signif icantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). CONCLUSION: The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.展开更多
AIM: To investigate the progression rate of small pancreatic cystic lesions and identify characteristics associated with their progression.METHODS: Patients with pancreatic cystic lesions with at least 1-year of follo...AIM: To investigate the progression rate of small pancreatic cystic lesions and identify characteristics associated with their progression.METHODS: Patients with pancreatic cystic lesions with at least 1-year of follow-up were evaluated retrospectively. We excluded patients with cysts larger than 3 cm or with features that were a concern for malignancy. In total, 135 patients were evaluated. The interval progression of the cysts was examined. Characteristics were compared between patients with and without progression.RESULTS: The pancreatic cysts ranged from 3 to 29 mm. The mean follow-up period was 4.5 ± 2.3 years and the mean progression rate was 1.0 ± 1.3 mm/year. Ninety patients showed interval progression and were divided into two groups; the minimal-change group(n = 41), who had cyst progression at less than 1 mm/year, and the progression group(n = 49), who had a progression rate of more than 1 mm/year. Compared with the cysts without progression, the lesions of the progression group were more frequently associated with tubular cyst, septation or a prominent pancreatic duct(P < 0.05). The odds ratio for progression was 5.318 for septation and 4.582 for tubular cysts.CONCLUSION: Small pancreatic cysts progress slowly. Lesions with tubular shape, septa, or prominent pancreatic duct were more likely to progress, and required further diagnostic intervention or shorter surveillance interval.展开更多
文摘AIM: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. METHODS: Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after drainage.RESULTS: Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not signif icantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). CONCLUSION: The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.
文摘AIM: To investigate the progression rate of small pancreatic cystic lesions and identify characteristics associated with their progression.METHODS: Patients with pancreatic cystic lesions with at least 1-year of follow-up were evaluated retrospectively. We excluded patients with cysts larger than 3 cm or with features that were a concern for malignancy. In total, 135 patients were evaluated. The interval progression of the cysts was examined. Characteristics were compared between patients with and without progression.RESULTS: The pancreatic cysts ranged from 3 to 29 mm. The mean follow-up period was 4.5 ± 2.3 years and the mean progression rate was 1.0 ± 1.3 mm/year. Ninety patients showed interval progression and were divided into two groups; the minimal-change group(n = 41), who had cyst progression at less than 1 mm/year, and the progression group(n = 49), who had a progression rate of more than 1 mm/year. Compared with the cysts without progression, the lesions of the progression group were more frequently associated with tubular cyst, septation or a prominent pancreatic duct(P < 0.05). The odds ratio for progression was 5.318 for septation and 4.582 for tubular cysts.CONCLUSION: Small pancreatic cysts progress slowly. Lesions with tubular shape, septa, or prominent pancreatic duct were more likely to progress, and required further diagnostic intervention or shorter surveillance interval.
