Intraoperative Biliary Drainage in Pancreaticoduodenectomy

Abstract

AIM: It is generally accepted that preoperative biliary drainage (PBD) in preventing the operative complications after pancreaticoduodenectomy (PD) in patients with deeply obstructive jaundice. However, whether PBD is beneficial in reducing complications after PD is still controversial. In this study, we compared the influence of with or without intraoperative biliary drainage (IBD) for decreasing the incidence of complication in PD without PBD.

METHODS: We retrospectively analyzed 40 patients who underwent PD without PBD with preoperative serum bilirubin level <5 mg/dL, either with IBD (IBD group) or without IBD (NIBD group). RESULTS: The serum level of bilirubin at the 7 d after the surgery was significantly higher in the NIBD group than in the IBD group (p<0.0176). However, no differences were observed between the 2 groups with respect to the serum level of AST, ALT, γ-GTP, and ALP at the 7 d after the surgery. There were no significant differences in postoperative complications between the 2 groups.

CONCLUSIONS: We consider IBD is useful to prevent postoperative liver damage; however, there is no significant differences in terms of postoperative complications with or without IBD in PD without PBD with preoperative serum bilirubin level <5 mg/dL.