The Influence Of Jaundice On Pancreaticoduodenectomy.

Objective To investigate the relation between jaundice and pancreaticoduodenec tomy(PD).Methods The clinical data of 72 cases underwent PD in our department from September, 1996 to February, 2007 were reviewed. These patients are divided into three groups according to clinical manifestation with or without jaundice and the level of total bilirubin(TBIL):group A,the patients who have no jaundice; group B, the cases who have jaundice with TBIL≤171umo1/L;group C, the cases who have jaundice with TBIL> 171umol/L,is divided into two groups:C1 and C2. group C1, the cases underwent preoperative drainage; group C2, the cases with out preoperative drainage. To investigate the relation between jaundice and the early complications after PD through analysising the clinical indexes of total bilirubin before PD, At last, to study wheather preoperative drainage is benefit for PD. Results 1.The cases of icterus gravi (TBIL>171umol/L) have a predominate higher incidence rate of early complications ( 68.2%) than the incidence of control group(40.5%). .The difference was statistically significant (χ2=4.218 ,P<0.05).The incidence rate of early complications were also compared among three groups one by one: group B has a higher rate of early complications than group A(χ2=4.361,P<0.05); there is the same result between group C and group A(χ2=7.832,P<0.05).2.The quantity of blood loss during operation of group C is higher than group B(χ2=4.546,P<0.05);As to alimentary tract hemorrhage after operation, the cases happened in group C is more than that in group B(χ2=3.956,P<0.05)。3. Preoperative drainage made operation time and The quantity of blood loss during operation more higher; On the postoperative complications and morbidity, preoperative drainage is not benefit for PD. Conclusion We consider jaundice a risk factor of postoperative complications. PD is a complex operation with high risk, the incidence of complications lies on not only the surgeon ,but also the jaundice before operation, however, if there is a good preparation, the operation should goes timely, preoperative drainage should be used cautiously。...