Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 4946-4953
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.4946
Biliary drainage strategy of unresectable malignant hilar strictures by computed tomography volumetry
Ei Takahashi, Mitsuharu Fukasawa, Tadashi Sato, Shinichi Takano, Makoto Kadokura, Hiroko Shindo, Yudai Yokota, Nobuyuki Enomoto
Ei Takahashi, Mitsuharu Fukasawa, Tadashi Sato, Shinichi Takano, Makoto Kadokura, Hiroko Shindo, Yudai Yokota, Nobuyuki Enomoto, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
Author contributions: Takahashi E analyzed and interpreted data, drafted the article, and performed biliary stenting; Fukasawa M conceived and designed the study, drafted the article, and performed biliary stenting; Sato T drafted the article and critically revised it for important intellectual content; Takano S, Kadokura M, Shindo H and Yokota Y performed biliary stenting and collected data; Enomoto N critically revised the manuscript for important intellectual content.
Ethics approval: The study was reviewed and approved by the University of Yamanashi Institutional Review Board.
Conflict-of-interest: None of the authors have any conflicts of interest.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mitsuharu Fukasawa, MD, PhD, First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan. fmitsu@yamanashi.ac.jp
Telephone: +81-5-52739584 Fax: +81-5-52736748
Received: October 15, 2014
Peer-review started: October 18, 2014
First decision: December 2, 2014
Revised: December 31, 2014
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: April 28, 2015
Core Tip

Core tip: An ideal biliary drainage strategy for unresectable malignant hilar biliary strictures (UMHBS) has not been defined. The aim of our study was to identify useful criteria for predicting successful drainage of UMHBS. In the present study, multivariate analysis revealed that liver function and drained liver volume calculated by computed tomography volumetry (CTV) are independent factors of drainage effectiveness for UMHBS. Receiver operating characteristic analysis showed cutoff values of 33% of liver volume for patients with preserved liver function and 50% for patients with impaired liver function. Before attempting biliary drainage procedures, establishing an appropriate drainage strategy using CTV is important.