Effect Of PBD On Patients Undergoing PD With Severe Malignant Obstructive Jaundice And Target Value Of PBD

Abstract Objects To evaluate the influence of preoperative biliary drainage on pancreatoduodenectomy(PD) for severe obstructive jaundice resulting from distal bile duct malignant tumors, and confirm a target value for preoperative biliary drainage(PBD).Methods We retrospectively analyzed the data of79patients who underwent PD for distal bile duct malignant tumors between January2001and December2011. The variable analyses were postoperative complications, postoperative hospital stay and postoperative mortality from PD severe obstructive group compared with PD mild obstructive group, post-PBD mild obstructive group compared with PD mild obstructive group preoperative mild obstructive group compared with PD severe obstructive group. Chi-square test. Fisher’s exact test, Student’s t-test were used as statistical methods (p<0.05defined as statistically significant difference).Results Comparing the incidence of postoperative complications between PD mild obstructive group and PD severe obstructive group, there was significant difference between the two groups (P=0.003); Comparing the postoperative mortality between PD mild obstructive group and PD severe obstructive group, there was no significant difference between the two groups (P=0.322); There was also no significant difference of postoperative hospital stay between the two groups (P=0.585). Comparing the incidence of postoperative complications between PD mild obstructive group and post-PBD mild obstructive group, there was no significant difference between the two groups (P=0.079); Comparing the postoperative mortality between PD mild obstructive group and post-PBD mild obstructive group, there was no significant difference between the two groups (P=1.000); There was also no significant difference of postoperative hospital stay between the two groups(P=0.141).Comparing the incidence of postoperative complications between preoperative mild obstructive group and PD severe obstructive group.there was significant difference between the two groups(P=0.026); Comparing the postoperative mortality between preoperative mild obstructive group and PD severe obstructive group,there was no significant difference between the two groups (P=0.130); There was also no significant difference of postoperative hospital stay between the two groups(P=0.665).Conclusions Obstructive jaundice have a severe effect upon the patients’psycholo-gical and physical health, accompanying obvious liver and renal function damage, which can ruin the postoperative recover. PBD can relieve the clinical symptoms remarkably and lessen the incidence of postoperative complications, which optimi-zes postoperative recovery. For the patients with severe obstructive jaundice (TBI L>170μmol/L), we suggest PBD should be executed in patients undergoing radical surgery and TBIL ought to be decreased to170μmol/L at lowest.