The impact of preoperative biliary drainage on surgical morbidity in hilar cholangiocarcinoma patients / 中华外科杂志
Chinese Journal of Surgery
;
(12): 1134-1137, 2009.
Article
in Chinese
| WPRIM
| ID: wpr-299715
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the impact of preoperative biliary drainage on surgical morbidity in hilar cholangiocarcinoma patients underwent surgery.</p><p><b>METHODS</b>One hundred and eleven consecutive patients with hilar cholangiocarcinoma whose serum total bilirubin (TBIL) level > 85 micromol/L and underwent surgery in the period from June 1998 to August 2007 were enrolled. There were 67 male and 44 female patients, aged from 26 to 82 years old with a mean of 56 years old.</p><p><b>RESULTS</b>Fifty-five patients underwent preoperative biliary drainage with a mean of 11.4 d of drainage period (drainage group), the other (n = 56) were the non-drainage group. The preoperative TBIL level of drainage group was (154 +/- 69) micromol/L, which was significantly lower than the value of pre-drainage (256 +/- 136) micromol/L (P = 0.000) and the value of non-drainage group (268 +/- 174) micromol/L (P = 0.005). ALT and GGT levels could be lowered by preoperative biliary drainage. The postoperative complications of these two groups were comparable (36.3% vs. 28.6%, P = 0.381). Four patients in drainage group and 5 patients in non-drainage group died of liver failure. Multivariate logistic regression indicated that hepatectomy (OR = 0.284, P = 0.003) was the independent risk factor associated with postoperative morbidity. Bismuth-Corlette classification (OR = 0.211, P = 0.028) was the independent risk factor linked to postoperative mortality.</p><p><b>CONCLUSIONS</b>Preoperative biliary drainage could alleviate liver injury due to hyperbilirubin, but it could not decrease the surgical morbidity and postoperative mortality. Concomitant hepatectomy and Bismuth-Corlette classification were independent risk factors linked to surgical risks.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
General Surgery
/
Bile Duct Neoplasms
/
Bile Ducts, Intrahepatic
/
Preoperative Care
/
Drainage
/
Retrospective Studies
/
Follow-Up Studies
/
Treatment Outcome
/
Cholangiocarcinoma
Type of study:
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
Chinese
Journal:
Chinese Journal of Surgery
Year:
2009
Type:
Article
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