Influence of preoperative biliary drainage on morbidity rate of severely obstructive jaundice patients after pancreaticoduodenectomy / 中国现代普通外科进展

ABSTRACT

Objective:To investigate the influence of preoperative biliary drainage (PBD) on morbidity of severely obstructive jaundice patients after pancreaticoduodenectomy (PD).Methods:A total of 98 severely obstructive jaundice(Serum total bilirubin＞300 μ mool/L) patients underwent PD between February 2010 and October 2015 were enrolled in the study.The patients were divided into two groups based on undergoing PBD or not.The no-PBD group comprised 52 patients and the PBD group comprised another 46 patients.Perioperatives parameters,including operative time,intraoperative blood loss,postoperative mortality and morbidity and postoperative hospital stay were compared between the two groups.Results:The demographics,preoperative examinations and pathological results were similar between the two groups (P＞0.05).Operative time of the no-PBD group was statistically longer than the PBD group (379.44 ± 88.57min vs 346.98 ± 57.17 min,P＜0.05).Besides,intraoperative blood loss of the no-PBD group were much more than the PBD group (365.00 ± 187.07mL vs 297.83 ± 139.57 mL,P＜0.05).There was no statistical difference of mortality rate between the no-PBD group and the PBD group(3.85％ vs 2.17％,P＞0.05).The overall morbidity rate of the 2 groups were similar (53.85％ vs 43.48％,P＞0.05),but the pancreatic fistula rate of no-PBD group was significantly higher than the PBD group (30.77％ vs 13.04％,P＜0.05).Conclusion:PBD could reduce operative time,intraoperative blood loss and pancreatic fistula rate after PD.Meanwhile,the mortality and overall morbidity rates were similar between the two groups.PBD should be considered for severely obstructive jaundice patients.