Effects Of Preoperative Biliary Drainage On The Outcome Of Pancreaticoduodenectomy Patients

Objective:The aim of this study is to evaluate the effects of preoperative biliary drainage(PBD) onthe operating time,blood loss and postoperative complications of pancreaticoduodenectomypatients to explore the proper index and length of PBD.Methods:We analyzed86patients with obstructive jaundice who underwentpancreaticoduodenectomy in our hospital from January2010to October2013retrospectively.The patients were divided into2groups:PBD group and non PBD groupaccording to whether they were underwent PBD.The operating time,blood loss andpostoperative complications were compared and analyzed between the two groups.Thepatients were divided into medium jaundice group(TBIL:171-342μmol/L) and severejaundice group(TBIL>342μmol/L) according to the preoperative jaundice level.Theoperating time,blood loss and postoperative complications were compared and analyzedbetween the PBD group and non PBD group in the different jaundice level.All the patientswho underwent PBD were divided into2groups:PBD10days group and PBD＞10daysgroup according to the different length of PBD.The operating time,blood loss andpostoperative complications were compared and analyzed between the two groups in thedifferent jaundice level.Results:(1)There is no statistical significance between the PBD group and non PBD group in theoperating time,blood loss and postoperative complications rate(P>0.05).(2)There is nostatistical significance between the PBD group and non PBD group in the operatingtime,blood loss and postoperative complications rate in the patients with mediumjaundice(P>0.05).(3)There is no statistical significance between the PBD and non PBD inthe postoperative complications rate in the patients with severe jaundice(P>0.05),but theoperating time,blood loss of the PBD group are significantly less than the non PBDgroup(P<0.05).(4)The operating time,blood loss of the PBD10days group aresignificantly more than the PBD＞10days group(P<0.05),but the postoperativecomplications has no statistical significance between the two groups(P>0.05).There is nostatistical significance between the PBD10days group and the PBD＞10days group in theoperating time,blood loss and postoperative complications rate in all the patients whounderwent PBD with medium jaundice(P>0.05).The operating time,blood loss and totalpostoperative complications rate of the PBD10days group are significantly more than thePBD＞10days group(P<0.05) in the patients who underwent PBD with severe jaundice.Conclusion:PBD does not influence the operating time,blood loss and postoperative complications ratein the patients with medium jaundice(TBIL:171-342μmol/L).PBD can help to reduce theblood loss and lower the difficulty level of operating in the patients with severejaundice.Suggest that PBD should be performed in the patients with severe jaundice and the length of PBD is better more than10days.