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Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy
Chandra Shekhar Bhati1, Chandrashekhar Kubal, Pankaj Kumar Sihag
1Upgraded Department of Surgery, SMS Medical College, Jaipur, India. c.s.bhati@bham.ac.uk
Aim:
To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticoduodenectomy.
Methods:
A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted.
Results:
Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable.
Conclusion:
Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.