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| 1 | Current status of preoperative drainage for distal biliary obstruction显示文摘Preoperative biliary drainage(PBD) was developed to improve obstructive jaundice, which affects a number of organs and physiological mechanisms in patients waiting for surgery. However, its role in patients who will undergo pancreaticoduodenectomy for biliary obstruction remains controversial. This article aims to review the current status of the use of preoperative drainage for distal biliary obstruction. Relevant articles published from 1980 to 2015 were identified by searching MEDLINE and Pub Med using the keywords 'PBD', 'pancreaticoduodenectomy', and 'obstructive jaundice'. Additional papers were identified by a manual search of the references from key articles. Current studies have demonstrated that PBD should not be routinely performed because of the postoperative complications. PBD should only be considered in carefully selected patients, particularly in cases where surgery had to be delayed. PBD may be needed in patients with severe jaundice, concomitant cholangitis, or severe malnutrition. The optimal method of biliary drainage has yet to be confirmed. PBD should be performed by endoscopic routes rather than by percutaneous routes to avoid metastatic tumor seeding. Endoscopic stenting or nasobiliary drainage can be selected. Although more expensive, the use of metallic stents remains a viable option to achieve effective drainage without cholangitis and reintervention. | Harutoshi Sugiyama Toshio Tsuyuguchi Yuji Sakai Rintaro Mikata Shin Yasui Yuto Watanabe Dai Sakamoto Masato Nakamura Reina Sasaki Jun-ichi Senoo Yuko Kusakabe Masahiro Hayashi Osamu Yokosuka | 2015 | World Journal of Hepatology2015，7，18： | 11 |
| 2 | Current status of endoscopic biliary drainage for unresectable malignant hilar biliary strictures显示文摘The management of jaundice and cholangitis is important for improving the prognosis and quality of life of patients with unresectable malignant hilar biliary strictures(UMHBS). In addition, effective chemotherapy, such as a combination of gemcitabine and cisplatin, requires the successful control of jaundice and cholangitis. However, endoscopic drainage for UMHBS is technical demanding, and continuing controversies exist in the selection of the most appropriate devices and techniques for stent deployment. Although metallic stents(MS) are superior to the usual plastic stents in terms of patency, an extensive comparison between MS and 'inside stents', which are deployed above the sphincter of Oddi, is necessary. Which techniques are preferred remains as yet unresolved: for instance, whether to use a unilateral or bilateral drainage, or a stent-in-stent or side-by-side method for the deployment of bilateral MS, although a new cell design and thin delivery system for MS allowed us to accomplish successful deployments of bilateral MS. The development of techniques and devices for re-intervention after stent occlusion is also imperative. Further critical investigations of more effective devices and techniques, and increased randomized controlled trials are warranted to resolve these important issues. | Hironari Kato Koichiro Tsutsumi Hirofumi Kawamoto Hiroyuki Okada | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，11： | 1 |
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