The Impact of Preoperative Biliary Drainage on Postoperative Outcomes after Pancreaticoduodenectomy: A Single Center Retrospective Study

Abstract

Background The effect of preoperative biliary drainage (PBD) on the short-term outcomes after pancreaticoduodenectomy (PD) remains controversial. Methods 164 consecutive patients with obstructive jaundice who underwent PD in our center from 2016 to 2017 were retrospectively analyzed. The 120 patients who underwent PBD prior to PD (PBD group) were compared with 44 patients who did not (DS group). The short-term outcomes include overall morbidity, severe complications, postoperative pancreatic fistula(POPF), postpancreatectomy hemorrhage(PPH), intra-abdominal abscess (IAA), sepsis, delayed gastric emptying (DGE), postoperative hospital stay and 90-day death were assesed. Results There were no significant statistical differences in overall morbidity, severe complications, POPF, PPH, IAA, LOS and ninety-day mortality between two groups. The incidence of DGE in PBD group was significantly lower than that in DS group (4.5% vs. 19.2%, P = 0.021). Multivariate regression analysis showed that age over 66 years (OR: 3.094,95% CI: 1.268-7.55) and direct surgery (OR: 5.298, 95% CI: 1.176-23.865) were independent risk factors for DGE. Conclusion For patients with obstructive jaundice, preoperative biliary drainage is independently associated with delayed gastric emptying, but does not affect the overall morbidity and mortality of patients undergoing PD.