title: Preoperative Cholangitis Affects Survival Outcome in Patients with Extrahepatic Bile Duct Cancer.
abstract: It remains controversial whether preoperative cholangitis affects long-term outcomes after resection in patients with extrahepatic bile duct cancer.
  
  
  
  A total of 107 patients with extrahepatic bile duct cancer who underwent resection with curative intent from 2008 to 2014 were retrospectively reviewed. Patients were categorized into two groups according to the presence or absence of preoperative cholangitis. Clinicopathological variables and long-term outcomes were compared in the two groups.
  
  
  
  In the preoperative cholangitis group, the rate of preoperative biliary drainage, the number of tube changes and/or additions, and the rate of lymph node metastasis were higher compared to the no-cholangitis group. Overall survival and disease-free survival were significantly worse in the cholangitis group compared to the no-cholangitis group (p = 0.022, p = 0.007). A poorer prognosis was not observed with an increasing grade of cholangitis in Tokyo Guidelines 2013 (p = 0.09). A multivariate logistic regression analysis revealed that the preoperative cholangitis was an independent prognostic factor for extrahepatic bile duct cancer.
  
  
  
  Preoperative cholangitis is an independent prognostic factor in patients with extrahepatic bile duct cancer regardless of the severity of the cholangitis.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Akita
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan. ajiki@med.kobe-u.ac.jp.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Shinozaki
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Goto
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Sadaki
authors.initials: S
authors.lastname: Asari
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Hirochika
authors.initials: H
authors.lastname: Toyama
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kido
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 6500017, Japan.
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D002761:Cholangitis / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
keywords: Bile duct cancer; Preoperative cholangitis; Prognosis