title: [Hilar bile duct tumors: Endoscopic or percutaneous drainage? A prospective analysis].
abstract: OBJECTIVE
  Both the endoscopic and the percutaneous approach are widely accepted for the drainage of hilar tumors. Our primary objective was to report on the effectiveness and complications of these procedures.
  
  
  METHODS
  Prospective observational analysis of the endoscopic and/or percutaneous management of all hilar tumors treated at a referral hospital from October 2011 until October 2014. Group A included patients treated endoscopically and group B included patients treated with percutaneous drainage. The following variables were assessed: Effective biliary drainage rate, survival time and complications.
  
  
  RESULTS
  Group A comprised 40 patients and group B, 22 patients. Overall success rate in achieving effective biliary drainage was 85% in group A and 90.9% in group B (p = 0.78). Five patients required a combined approach. In group A, the rate of effective drainage in patients with Bismuth IV-type tumors was 58.3%, while it was 81.8% in patients in group B (p = 0.44). There was no difference in mean survival between both groups. For group A, complication rate was 11.5%, whereas it was 2.94% for group B (p = 0.41).
  
  
  CONCLUSIONS
  Endoscopic and percutaneous biliary drainage are both effective methods for the palliative treatment of patients with hilar tumors. However, for Bismuth IV-type strictures, percutaneous drainage proved to be safer and more effective.
authors.forename: Martín Alejandro
authors.initials: MA
authors.lastname: Guidi
authors.forename: Cecilia
authors.initials: C
authors.lastname: Curvale
authors.forename: Juan
authors.initials: J
authors.lastname: Viscardi
authors.forename: Hui Jer
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Julio César
authors.initials: JC
authors.lastname: de María
authors.forename: Esteban
authors.initials: E
authors.lastname: Promenzio
authors.forename: Fernando
authors.initials: F
authors.lastname: Ragone
authors.forename: Raúl Fernando
authors.initials: RF
authors.lastname: Matanó
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications*; D001653:Bile Ducts, Intrahepatic; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002780:Cholestasis, Intrahepatic / Q000209:etiology / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome