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Gastroenterology Research and Practice
Volume 2015 (2015), Article ID 796893, 8 pages
http://dx.doi.org/10.1155/2015/796893
Research Article

Association of Preoperative Biliary Drainage with Postoperative Morbidity after Pancreaticoduodenectomy

Chang Liu,1,2,3 Jian-Wen Lu,1,2,3 Zhao-Qing Du,1,2,3 Xue-Min Liu,1,2,3 Yi Lv,1,2,3 and Xu-Feng Zhang1,2,3

1Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
2Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
3Shaanxi Provincial Regenerative Medicine and Surgical Engineering Research Center, Xi’an, Shaanxi 710061, China

Received 23 June 2015; Revised 8 August 2015; Accepted 20 September 2015

Academic Editor: Waldemar Uhl

Copyright © 2015 Chang Liu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 mol/L versus 136.0 mol/L, ). 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 ( and 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%, ). Conclusions. PBD seems to moderately increase the risk of postoperative wound and bile duct infection. Therefore, PBD should be selectively performed prior to PD.