Association of Preoperative Biliary Drainage with Postoperative Morbidity after Pancreaticoduodenectomy

Gastroenterology Research and Practice
Chang LiuXu-Feng Zhang

Abstract

Background. The advantages or disadvantages of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) remain unclear. Methods. A prospectively maintained database was queried for 335 consecutive patients undergoing standard PD surgery between 2009 and 2013. Clinical data and postoperative complications of the 47 patients receiving PBD and 288 patients with early surgery were compared. A matching analysis was also performed between patients receiving or not receiving PBD (no-PBD). Results. The indication for PBD was severe obstructive jaundice (81%) and cholangitis (26%) at the time of PBD. 47 PBD patients had higher bilirubin level than 288 no-PBD patients preoperatively (363.2 μmol/L versus 136.0 μmol/L, p < 0.001). Although no significant difference of any complications could be observed between the two groups, positive intraoperative bile culture and wound infection seemed to be moderately increased in PBD compared to no-PBD patients (p = 0.084 and 0.183, resp.). In the matched-pair comparison, the incidence of wound infection was three times higher in PBD than no-PBD patients (14.9% versus 4.3%, p = 0.080). Conclusions. PBD seems to moderately increase the risk of postoperative wound and bile duct infecti...Continue Reading

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Citations

Sep 12, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Marta SandiniLuca Gianotti
Jul 15, 2017·Surgery Today·Alban Zarzavadjian Le BianRenato Costi
Nov 22, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mohammad HamidiMohammad Khreiss

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