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Comparison of Clinical Outcome and Cost-Effectiveness after Various Preoperative Biliary Drainage Methods in Periampullary Cancer with Obstructive Jaundice
Journal of Korean Medical Science ; : 356-362, 2012.
Artigo em Inglês | WPRIM | ID: wpr-143932
ABSTRACT
The aim of this study was to compare the clinical outcome and cost-effectiveness of preoperative biliary drainage (BD) methods in periampullary cancer, and to suggest guidelines for selecting the appropriate preoperative BD method. Between October 2004 and August 2010, 211 patients underwent pancreatoduodenectomy after preoperative BD. Clinical outcome and cost-effectiveness of the preoperative BD methods were compared based on the final drainage method used and on intention-to-treat analysis. There was no significant difference in drainage duration between percutaneous transhepatic biliary drainage (PTBD) and endoscopic BD groups (14.2 vs 16.6 days, respectively; P = 0.121) but daily diminution of serum bilirubin level was higher in the PTBD group (0.7 vs 0.6 mg/dL/day, respectively; P = 0.041). Based on intention-to-treat analysis, drainage duration was shorter (13.2 vs 16.5 days, respectively; P = 0.049), daily diminution of serum bilirubin level was higher (0.7 vs 0.6 mg/dL/day, respectively; P = 0.041). Medical care cost was lower (14.2 vs 15.7 x 10(3) USD, respectively; P = 0.040) in the PTBD group than in the endoscopic BD group. When selecting the preoperative BD method, practitioners should consider that PTBD is more cost-effective and safer than endoscopic BD.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Pancreáticas / Complicações Pós-Operatórias / Fatores de Tempo / Bilirrubina / Cuidados Pré-Operatórios / Drenagem / Estudos Retrospectivos / Resultado do Tratamento / Pancreaticoduodenectomia / Análise Custo-Benefício Tipo de estudo: Guia de Prática Clínica / Avaliação Econômica em Saúde / Estudo observacional Limite: Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2012 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Neoplasias Pancreáticas / Complicações Pós-Operatórias / Fatores de Tempo / Bilirrubina / Cuidados Pré-Operatórios / Drenagem / Estudos Retrospectivos / Resultado do Tratamento / Pancreaticoduodenectomia / Análise Custo-Benefício Tipo de estudo: Guia de Prática Clínica / Avaliação Econômica em Saúde / Estudo observacional Limite: Idoso / Feminino / Humanos / Masculino Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2012 Tipo de documento: Artigo