The Effect Of Preoperative Bilirubin Level And Preoperative Bililary Drainage On Pancreatoduodenectomy

Objective:Through the analysis of the influence of preoperative serum total bilirubin level in patients undergoing resection of pancreas,in order to explore the optimal level of preoperative bilirubin reduction should be controlled,and summed up the value and the clinical significance of carry on Preoperative jaundice reduction for the patients with obstructive jaundice,to guide the clinical response of malignant obstructive jaundice.Methods:The data of patients undergoing pancreaticoduodenectomy in the general surgery department of the First Affiliated Hospital of Nanchang University from 2015-07 to2017-07 were analyzed statistically.Bilirubin was divided into two groups at171umol/L level.Statistics of different groups of gender and age of patients,preoperative serum transaminase,albumin,hemoglobin,tumor size,tumor location,operation time,intra-operative blood transfusion,postoperative hospital stay,postoperative complication,analysis and treatment between the two groups;then according to the preoperative jaundice were divided into two groups,statistics the postoperative pancreatic fistula,postoperative bleeding,then a comparative analysis.To find the influence and relationship of bilirubin on various factors,so as to explore the influence of bilirubin level on pancreatoduodenectomy and clarify the level of bilirubin before operation.Results:Compared bilirubin higher than 171umol/L group with less than 171umol/L group in age,gender,the weight,the differences have no statistically significant(P>0.05);the two groups were compared before TBIL,ALT,AST,ALB level,the differences were statistically significant(P<0.05);Preoperative hemoglobin,intraoperative bleeding,postoperative hospital stay,operation time and blood transfusion were compared between the two groups,and there were no significant difference(P > 0.05);the comparation between two group of tumor size and thetumor position,the differences were statistically significant(P<0.05).two groups of post-operative other complications occurred rate comparison,there was no significant difference between groups(P>0.05);The total incidence of post-operative complications in reduction of jaundice and nun-reduction before operation was statistically significant(P<0.05),and the difference was statistically significant compared with ≥600ml and < 600ml(P < 0.05).Conclusion:High level of bilirubin before operation seriously affects liver function and coagulation function;Preoperative bilirubin level is related to the diameter and location of tumor;High level bilirubin increased overall postoperative complications;Effective preoperative reduction of jaundice can improve coagulation function and reduce intraoperative blood loss;Effective preoperative reduction of jaundice can reduce the incidence of postoperative complications.