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Effect of preoperative biliary drainage on surgical results after pancreaticoduodenectomy in patients with distal common bile duct cancer: Focused on the rate of decrease in serum bilirubin

2008; Baishideng Publishing Group; Volume: 14; Issue: 7 Linguagem: Inglês

10.3748/wjg.14.1102

2219-2840

Yun Mee Choi, Eung‐Ho Cho, Keon‐Young Lee, Seung‐Ik Ahn, Sun Keun Choi, Sei Joong Kim, Yoon Seok Hur, Young Up Cho, Kee-Chun Hong, Seok-Hwan Shin, Kyung Rae Kim, Ze‐Hong Woo,

Gallbladder and Bile Duct Disorders

AIM:To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct cancer. METHODS:A retrospective study was performed in 49 consecutive patients who underwent pancreaticoduodenectomy for distal common bile duct cancer.Potential risk factors were compared between the complicated and uncomplicated groups.Also, the rates of decrease in serum bilirubin were compared pre-and postoperatively. RESULTS:Preoperative biliary drainage (PBD) was performed in 40 patients (81.6%).Postoperative morbidity and mortality rates were 46.9% (23/49) and 6.1% (3/49), respectively.The presence or absence of PBD was not different between the complicated and uncomplicated groups.In patients with PBD, neither the absolute level nor the rate of decrease in serum bilirubin was significantly different.Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week (5.5 ± 4.4 μmol/L vs -1.7 ± 9.9 μmol/L, P = 0.004).CONCLUSION: PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer.There is a certain group of patients with a compromised hepatic excretory function, which is represented by the slow rate of decrease in serum bilirubin after PBD.