2026-10-14T08:12:41Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34018811 2026-09-29T00:48:02Z category_7 category_13 category_15 category_272 category_46 category_64 category_106 category_132 category_135 portal_87 item_type_3 month_year_09_2026

Preoperative biliary drainage in resectable perihilar cholangiocarcinoma: real-world burden Noa Toussaint (25133579) Arthur Marichez (25133582) Mehdi Boubaddi (25133585) Bruno Lapuyade (7302626) Christophe Laurent (1684942) Laurence Chiche (7302638) Medicine Genetics Neuroscience Environmental Sciences not elsewhere classified Immunology Cancer Science Policy Infectious Diseases Computational Biology Curative-intent surgery disease-free survival endoscopic biliary drainage percutaneous transhepatic biliary drainage perihilar cholangiocarcinoma prognostic factors <p>Preoperative biliary drainage (PBD) in perihilar cholangiocarcinoma (pCCA) remains challenging, and its burden among patients who ultimately do not undergo curative-intent surgery is uncertain. We characterized the PBD pathway and identify factors associated with failure of curative-intent management.</p> <p>This retrospective, single-center cohort study included 109 patients with initially resectable pCCA requiring PBD at a tertiary hepatobiliary center between 2010 and 2025. Drainage sequences, complications, surgical and oncological outcomes, and factors associated with surgical exclusion or 90-day mortality were assessed.</p> <p>Resection was achieved in 84 patients (77.1%). Repeated drainage increased septic morbidity (83.1% vs 62.0%, <i>p</i> = 0.013). Pancreatitis with a CT Severity Index ≥4 or severe acute pancreatitis was associated with surgical exclusion (50.0% vs 20.2%, <i>p</i> = 0.048). Drainage-related septic complications independently predicted impaired disease-free survival (HR 3.69, 95%CI 1.58–8.59, <i>p</i> = 0.002). A 7-point score including age >70 years, arterial hypertension, post-drainage pancreatitis, and post-drainage septic complications predicted surgical exclusion or 90-day mortality (AUC 0.766).</p> <p>PBD carries substantial morbidity and may compromise the curative pathway for resectable pCCA. Early expert referral and planned first-attempt drainage are essential. Optimal management of the PBD period before surgery may help to reduce the burden of the surgical resection.</p> 2026-09-29T00:48:02Z Dataset Dataset 10.6084/m9.figshare.34018811.v1 https://figshare.com/articles/dataset/Preoperative_biliary_drainage_in_resectable_perihilar_cholangiocarcinoma_real-world_burden/34018811 CC BY 4.0