title: Preoperative biliary drainage-related inflammation is associated with shorter survival in biliary tract cancer patients.
abstract: BACKGROUND
  An association between inflammation and patient prognosis has been reported in various types of cancer. The aim of this study was to evaluate the influence of preoperative biliary drainage-related inflammation in patients with biliary tract cancer.
  
  
  METHODS
  The clinical data of 97 patients who underwent surgery for extrahepatic bile duct cancer between February 2002 and September 2014 were analyzed, and the prognostic significance of tube-obstructive cholangitis after preoperative biliary drainage and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) was evaluated.
  
  
  RESULTS
  Eighty-four (86.6 %) of the 97 patients underwent ERCP and preoperative biliary drainage. Tube-obstructive cholangitis occurred in 25 cases and post-ERCP pancreatitis in 8 cases. Collectively, 30 patients experienced preoperative biliary drainage-related inflammation consisting of tube-obstructive cholangitis and/or post-ERCP pancreatitis. Drainage-related inflammation was significant risk factor of postoperative complications (P = 0.006), and significant poor predictors of shorter progression-free survival (P = 0.003) and overall survival (OS; P = 0.006) after surgery. In multivariate analysis, drainage-related inflammation was an independent predictor of shorter OS (hazard ratio, 1.924; P = 0.037) after surgery.
  
  
  CONCLUSIONS
  Preoperative biliary drainage-related inflammation was an independent prognostic factor for shorter OS in biliary tract cancer patients.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan. h-krhr@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Mataki
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sakoda
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iino
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yota
authors.initials: Y
authors.lastname: Kawasaki
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Arigami
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Uenosono
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.affiliation: Health Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.affiliation: Frontier Science Research Center, Kagoshima University, Kagoshima, Japan.
authors.forename: Sonshin
authors.initials: S
authors.lastname: Takao
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D002761:Cholangitis / Q000150:complications* / Q000209:etiology; D018572:Disease-Free Survival; D004322:Drainage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000150:complications* / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D011300:Preoperative Care / Q000009:adverse effects; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
keywords: Cholangitis; ERCP; Pancreatitis; Prognosis