The effect of preoperative biliary stenting on postoperative complications after pancreaticoduodenectomy
| Autor: | Jack Pickleman, Pamela J. Hodul, Gerard V. Aranha, Steve Creech |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Blood Loss Surgical Biliary Stenting Pancreaticoduodenectomy Postoperative Complications Laparotomy Preoperative Care medicine Bile Humans Surgical Wound Infection Aged medicine.diagnostic_test business.industry Incidence (epidemiology) General Medicine Middle Aged medicine.disease Endoscopy Surgery Jaundice Obstructive Biliary tract Pancreatic fistula Case-Control Studies Drainage Female Stents Complication business |
| Zdroj: | The American Journal of Surgery. 186:420-425 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2003.07.005 |
| Popis: | Background Preoperative biliary drainage (PBD) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial. Methods Patients presenting with obstructive jaundice who subsequently underwent pancreaticoduodenectomy from January 1996 to June 2002 were included in the study (n = 212). Patients with preoperative biliary stents (n = 154) were compared with patients without preoperative drainage (n = 58). Results Patients in the stented group required a longer operative time (mean 6.8 hours versus 6.5 hours) and had greater intraoperative blood loss (mean 1207 mL versus 1122 mL) compared with the unstented group, (P = 0.046 and 0.018). No differences were found with respect to operative mortality (2%), incidence of pancreatic fistula (10% versus 14%), or intraabdominal abscess (7% versus 5%). Wound infection occurred more often in the stented group (8% versus 0%, P = 0.039). Conclusions PBD was associated with increased operative time, intraoperative blood loss, and incidence of wound infection. Although PBD did not increase major postoperative morbidity and mortality, it should be used selectively in patients undergoing pancreaticoduodenectomy. |
| Databáze: | OpenAIRE |
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