Yuji Kitahata1, Manabu Kawai1, Masaji Tani1, Seiko Hirono1, Ken-ichi Okada1, Motoki Miyazawa1, Atsushi Shimizu1, Hiroki Yamaue2. 1. Second Department of Surgery, Wakayama Medical University School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan. 2. Second Department of Surgery, Wakayama Medical University School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan. Electronic address: yamaue-h@wakayama-med.ac.jp.
Abstract
BACKGROUND: It remains controversial how preoperative biliary drainage affects occurrence of severe complications after pancreaticoduodenectomy (PD). METHODS: One hundred twenty-seven patients (60 external drainage and 67 internal drainage) required biliary drainage before PD were retrospectively reviewed. RESULTS: Preoperative cholangitis in internal drainage group (22.4%) occurred significantly more often than in external drainage group (1.7%; P < .001). The incidence of severe complications (grade III or more) was significantly higher in patients with cholangitis (62.5%) than in those without it (25.2%; P = .002). The incidence of delayed gastric emptying was significantly higher in patients with cholangitis (31.2%) than in those without it (5.4%; P = .001). A multivariate logistic regression analysis revealed that preoperative cholangitis (odds ratio 4.61, 95% confidence interval 1.3 to 16.5; P = .019) was the independent risk factor for severe complications after PD. CONCLUSIONS: Preoperative cholangitis during biliary drainage significantly increases incidence of severe complications after PD.
BACKGROUND: It remains controversial how preoperative biliary drainage affects occurrence of severe complications after pancreaticoduodenectomy (PD). METHODS: One hundred twenty-seven patients (60 external drainage and 67 internal drainage) required biliary drainage before PD were retrospectively reviewed. RESULTS: Preoperative cholangitis in internal drainage group (22.4%) occurred significantly more often than in external drainage group (1.7%; P < .001). The incidence of severe complications (grade III or more) was significantly higher in patients with cholangitis (62.5%) than in those without it (25.2%; P = .002). The incidence of delayed gastric emptying was significantly higher in patients with cholangitis (31.2%) than in those without it (5.4%; P = .001). A multivariate logistic regression analysis revealed that preoperative cholangitis (odds ratio 4.61, 95% confidence interval 1.3 to 16.5; P = .019) was the independent risk factor for severe complications after PD. CONCLUSIONS: Preoperative cholangitis during biliary drainage significantly increases incidence of severe complications after PD.
Authors: Sebastian Cammann; Kai Timrott; Ralf-Peter Vonberg; Florian W R Vondran; Harald Schrem; Sebastian Suerbaum; Jürgen Klempnauer; Hüseyin Bektas; Moritz Kleine Journal: Langenbecks Arch Surg Date: 2016-05-28 Impact factor: 3.445