Preoperative Biliary Drainage Increases Infectious Complications after Hepatectomy for Proximal Bile Duct Tumor Obstruction

2008 ◽  
Vol 33 (2) ◽  
pp. 318-325 ◽  
Author(s):  
Alessandro Ferrero ◽  
Roberto Lo Tesoriere ◽  
Luca Viganò ◽  
Luisa Caggiano ◽  
Enrico Sgotto ◽  
...  
Keyword(s):  
Bile Duct ◽  
Biliary Drainage ◽  
Infectious Complications ◽  
Preoperative Biliary Drainage ◽  
Bile Duct Tumor ◽  
Proximal Bile Duct

Postoperative Outcome after Major Liver Resection in Jaundiced Patients with Proximal Bile Duct Cancer without Preoperative Biliary Drainage

2015 ◽  
Vol 32 (6) ◽  
pp. 426-432 ◽  
Author(s):  
Mohamed Abdel Wahab ◽  
Ehab El Hanafy ◽  
Ayman El Nakeeb ◽  
Emad Hamdy ◽  
Ehab Atif ◽  
...  
Keyword(s):  
Liver Resection ◽  
Bile Duct ◽  
Biliary Drainage ◽  
Bile Duct Cancer ◽  
Postoperative Outcome ◽  
Preoperative Biliary Drainage ◽  
Major Liver Resection ◽  
Liver Remnant ◽  
Duct Cancer ◽  
Proximal Bile Duct

Background/Aims: The need for routine use of preoperative biliary drainage (PBD) before major liver resection in jaundiced patients has recently been questioned. Our aim was to present our experience of patients with proximal bile duct cancer who undergo major liver resection without PBD and compare these results with patients without biliary obstruction who underwent major liver resection. Methods: Eighty six consecutive jaundiced patients underwent major liver resection without PBD. The postoperative outcome was compared to the control group, which was the same size and matched. Design: A case-comparison study. Results: Fifty nine jaundiced patients (69%) and 22 non-jaundiced patients (25%) received blood transfusion (p = 0.04). Fifty-three patients (62%) in the jaundiced group and 17 (19%) in the non-jaundiced patients experienced postoperative complications (p = 0.003). A statistically significant difference could not be detected for mortality (6 vs. 2%) and transient liver failure (10 vs. 3%). Those patients who underwent extended right hemihepatectomy (with future liver remnant <50%) express high morbidity (55 vs. 24%; p = 0.04) and mortality (23 vs. 8%; p = 0.001) compared to the non-jaundiced patients. Conclusions: Major liver resection without PBD leaving a liver remnant of more than 50% is safe in jaundiced patients. However, transfusion requirement and morbidity are higher in jaundiced patients than in non-jaundiced patients.

Preoperative biliary drainage for distal biliary obstruction and post-operative infectious complications

2012 ◽  
Vol 83 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Wee Ngu ◽  
Michael Jones ◽  
Chrisopher P. Neal ◽  
Ashley R. Dennison ◽  
Matthew S. Metcalfe ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Biliary Obstruction ◽  
Infectious Complications ◽  
Preoperative Biliary Drainage

The additional value of diagnostic laparoscopy in the work-up of patients with a proximal bile duct tumor

2001 ◽  
Vol 120 (5) ◽  
pp. A89-A89
Author(s):  
E TILLEMAN ◽  
S CASTRO ◽  
O BUSCH ◽  
T GULIK ◽  
H OBERTOP ◽  
...  
Keyword(s):  
Bile Duct ◽  
Diagnostic Laparoscopy ◽  
Bile Duct Tumor ◽  
Additional Value ◽  
Work Up ◽  
Proximal Bile Duct

Efficacy of endoprosthesis for internal biliary drainage in patients with nonresectable carcinoma of the proximal bile duct

1984 ◽  
Vol 14 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Okitsugu Nishimura ◽  
Toshiko Hisaki ◽  
Yoshihiro Kawamura ◽  
Toshinari Odachi ◽  
Haruaki Ogawa ◽  
...  
Keyword(s):  
Bile Duct ◽  
Biliary Drainage ◽  
Proximal Bile Duct

scholarly journals The Effect of Preoperative Biliary Drainage with or without Pancreatic Stenting on Complications after Pancreatoduodenectomy: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jiangtao Chu ◽  
Shun He ◽  
Yan Ke ◽  
Xudong Liu ◽  
Peng Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bile Duct ◽  
Postoperative Complications ◽  
Pancreatic Duct ◽  
Anastomotic Leakage ◽  
Complication Rate ◽  
Biliary Drainage ◽  
Preoperative Biliary Drainage ◽  
Gastrointestinal Dysfunction ◽  
Pancreatic Duct Stenting

Background. The necessity of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) is still controversial. However, in some settings, PBD with endoscopic retrograde cholangiopancreatography (ERCP) procedure is recommended as a preferred management. Meanwhile, pancreatic duct stenting in the drainage procedure is rarely performed for selected indications, and its associated complications after PD remain quite unknown. Methods. A retrospective observational longitudinal cohort study was performed on patients who underwent PBD and PD from a prospectively maintained database at the National Cancer Center from March of 2015 to July of 2019. Patients who underwent biliary stenting alone, biliary and pancreatic stenting, were distributed into two study cohort groups, and their records were scrutinized for the incidence of postoperative complications. Results. A total of 83 patients who underwent successful PD after biliary drainage were identified. 29 patients underwent nasobiliary drainage (ENBD)/plastic or metal bile duct stenting (BS) and pancreatic duct stenting (PS group), and 54 patients underwent only ENBD/BS, without pancreatic duct stenting (NPS group). No differences were found between the two groups with respect to in-hospital time, overall complication rate, respective rate of serious (grade 3 or higher) complication rate, bile anastomotic leakage, bleeding, abdominal infection, surgical wound infection, organ dysfunction, and pancreatic anastomotic leakage. Postoperative gastrointestinal dysfunction rates differed significantly, which occurred in 3 (5.56%) cases in the NPS group, compared with 6 (20.7%) cases in the PS group ( P = 0.06 ). In the univariate and multivariate regression model analysis, pancreatic duct stenting was correlated with higher rates of gastrointestinal dysfunction [ odds   ratio   OR = 4.25 , P = 0.0472 ]. Conclusion. Our data suggested that PBD and pancreatic duct stenting prior to pancreatoduodenectomy would increase the risk of postoperative delayed gastric emptying, while the overall incidence of postoperative complications and other complications, such as pancreatic leakage and bile duct leakage, showed no statistical difference.

scholarly journals Association of Preoperative Biliary Drainage with Postoperative Morbidity after Pancreaticoduodenectomy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Chang Liu ◽  
Jian-Wen Lu ◽  
Zhao-Qing Du ◽  
Xue-Min Liu ◽  
Yi Lv ◽  
...  
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Obstructive Jaundice ◽  
Wound Infection ◽  
Biliary Drainage ◽  
Postoperative Morbidity ◽  
Preoperative Biliary Drainage ◽  
Matched Pair ◽  
Postoperative Wound ◽  
Significant Difference

Background. The advantages or disadvantages of preoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) remain unclear.Methods. A prospectively maintained database was queried for 335 consecutive patients undergoing standard PD surgery between 2009 and 2013. Clinical data and postoperative complications of the 47 patients receiving PBD and 288 patients with early surgery were compared. A matching analysis was also performed between patients receiving or not receiving PBD (no-PBD).Results. The indication for PBD was severe obstructive jaundice (81%) and cholangitis (26%) at the time of PBD. 47 PBD patients had higher bilirubin level than 288 no-PBD patients preoperatively (363.2 μmol/L versus 136.0 μmol/L,p<0.001). Although no significant difference of any complications could be observed between the two groups, positive intraoperative bile culture and wound infection seemed to be moderately increased in PBD compared to no-PBD patients (p=0.084and 0.183, resp.). In the matched-pair comparison, the incidence of wound infection was three times higher in PBD than no-PBD patients (14.9% versus 4.3%,p=0.080).Conclusions. PBD seems to moderately increase the risk of postoperative wound and bile duct infection. Therefore, PBD should be selectively performed prior to PD.

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