[Clinical significance of preoperative biliary drainage for patients with moderate jaundice: a prospective...

To evaluate the preoperative necessity of reducing moderate icterus index (preoperative serum total bilirubin of 171 to 342 mmol/L) in obstructive jaundice patients.

A prospective non- randomized control method was used to divide 105 patients into jaundice-reducing (n = 58) and non-reducing (n = 47) group. And the intraoperative and postoperative parameters were compared between two groups.

In jaundice-reducing group, the level of total bilirubin decreased from (264 ± 76) mmol/L to (183 ± 44) mmol/L after biliary drainage (P < 0.001). There were no significant inter-group differences in operative duration, blood loss, inpatient days or postoperative inpatient days (P > 0.05). There was no perioperative mortality in jaundice-reducing group while two perioperative mortalities occurred in another group. There was no significant inter-group difference in perioperative mortality rate (P = 0.423). The postoperative complication rate of jaundice-reducing group (n = 16, 27.59%) was slightly lower than that of non-reducing group (n = 14, 29.79%). However, the difference was insignificant (P = 0.471). Stratified analysis showed that there was no significant inter-group difference in single complication (wound infection, postoperative hemorrhage, pancreatic fistula, biliary fistula, delayed gastric emptying, abdominal infection, lung infection or cardiovascular complications, etc.) (all P > 0.05).

The preoperative necessity is limited for reducing moderate icterus index in obstructive jaundice patients. They should be operated as soon as possible once there is a definite diagnosis.