Preoperative biliary drainage adversely affects surgical outcomes in periampullary cancer: a retrospective and propensity score‐matched analysis

Lee, Hongeun; Han, Youngmin; Kim, Jae Ri; Kwon, Wooil; Kim, Sun Whe; Jang, Jin Young

doi:10.1002/jhbp.529

Cited by 29 publications

(20 citation statements)

References 32 publications

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“…Surgical outcomes following PD have largely improved due to advances in perioperative management and medical knowledge (14). Nevertheless, surgical outcomes are determined not only by tumor characteristics, but also by associated jaundice due to biliary obstruction, patient characteristics, and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

et al. 2021

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Background: Preoperative biliary drainage prior to pancreaticoduodenectomy (PD) by percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary drainage (EBD) is performed to improve liver functions, including immunity and coagulation that affect postoperative recovery in patients with jaundice.EBD can be performed through endoscopic retrograde biliary drainage (ERBD) or endoscopic nasobiliary drainage (ENBD). There is no clear consensus about which drainage is more suitable for preoperative EBD.

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Section: Discussionmentioning

confidence: 99%

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

et al. 2021

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“…22 However, some studies reported an increase in infectious complication in patients who received PBD prior to undergoing PD. 23 At Ramathibodi Hospital, the presenting symptom of obstructive jaundice is very prevalent, with most patients having a mean total bilirubin level of 12.5 mg/dL at the time of diagnosis. This value is relatively greater than other previously reported studies.…”

Section: Discussionmentioning

confidence: 99%

Association of the rate of bilirubin decrease with major morbidity in patients undergoing preoperative biliary drainage before pancreaticoduodenectomy

et al. 2021

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Objective: The objective of this study was to examine the relationship between the rate of bilirubin decrease following preoperative biliary drainage before pancreaticoduodenectomy and postoperative morbidity. Methods: Records of patients who underwent pancreaticoduodenectomy at the Department of Surgery in Ramathibodi Hospital between January 2008 and December 2019 were retrospectively reviewed. The patients were classified into either an adequate or inadequate drainage rate groups according to the bilirubin decrease rate. Major morbidity was defined as higher than grade II in the Clavien-Dindo classification. Risk factors for major morbidity were analyzed by logistic regression analysis. Results: In total, 166 patients were included in the study. Major morbidity was observed in 36 patients (21.6%). Adequate biliary drainage rate was observed in 39 patients (23.4%). Patients who had major morbidity were less likely to have come from the adequate biliary drainage rate group than the inadequate group (38.9% vs. 61.1%). However, through multivariate logistic analysis, only body mass index, operative time, and pancreatic duct diameter were independent factors associated with major morbidity, whereas the bilirubin decrease rate was not. Conclusions: Bilirubin decrease rate following preoperative biliary drainage has no significant association with major postoperative morbidity after pancreaticoduodenectomy.

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“…Prior reports have studied outcomes after biliary drainage with varying results in highly selected groups of patients with malignant biliary obstruction [8,23], acute cholangitis [14], post-liver transplant [24,25], and postsurgical bile leakage [26]. Our study provides a headto-head comparison of hospitalization outcomes for all common clinical diagnoses of patients undergoing PBIs.…”

Section: Role Of Underlying Clinical Diagnosismentioning

confidence: 99%

Characteristics and Outcomes of Percutaneous Biliary Interventions in the United States

Hafezi-Nejad

Bailey

Areda

et al. 2021

Journal of the American College of Radiology

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Preoperative biliary drainage adversely affects surgical outcomes in periampullary cancer: a retrospective and propensity score‐matched analysis

Abstract: Preoperative biliary drainage, especially EBD, should not be routinely performed in patients awaiting surgery for periampullary cancer, as it increases the risk of complications.

Cited by 29 publications

References 32 publications

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

Association of the rate of bilirubin decrease with major morbidity in patients undergoing preoperative biliary drainage before pancreaticoduodenectomy

Characteristics and Outcomes of Percutaneous Biliary Interventions in the United States

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