Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy

doi:10.3748/wjg.v13.i8.1240

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Feb 28, 2007 (publication date) through Apr 18, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Feb 28, 2007; 13(8): 1240-1242
Published online Feb 28, 2007. doi: 10.3748/wjg.v13.i8.1240

Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy

Chandra Shekhar Bhati, Chandrashekhar Kubal, Pankaj Kumar Sihag, Ankur Atal Gupta, Raj Kamal Jenav, Nicholas G Inston, Jagdish M Mehta

Chandra Shekhar Bhati, Pankaj Kumar Sihag, Ankur Atal Gupta, Raj Kamal Jenav, Jagdish M Mehta, Upgraded Department of Surgery, SMS Medical College, Jaipur, India

Chandra Shekhar Bhati, Chandrashekhar Kubal, Nicholas G Inston, Liver Unit, Queen Elizabeth Hospital, Birmingham, United Kingdom

Author contributions: All authors contributed equally to the work.

Correspondence to: Chandra Shekhar Bhati, MS, MRCS, Research registrar, Department of HPB Surgery and Liver Transplantation, Queen Elizabeth Hospital, Birmingham, United Kingdom. c.s.bhati@bham.ac.uk

Telephone: +44-1216-271627

Received: November 28, 2006
Revised: December 13, 2006
Accepted: January 17, 2007
Published online: February 28, 2007

Abstract

AIM: To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticoduodenectomy.

METHODS: A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted.

RESULTS: Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable.

CONCLUSION: Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.

Keywords: Whipple’s operation, Preoperative stenting, Sepsis, Preoperative biliary drainage