Effect of preoperative biliary drainage on surgical results after pancreaticoduodenectomy in patients with distal common bile duct cancer:Focused on the rate of decrease in serum bilirubin  

作　　者：Yun Mee Choi Eung-Ho Cho Keon-Young Lee Seung-Ik Ahn Sun Keun Choi Sei Joong Kim Yoon Seok Hur Young Up Cho Kee-Chun Hong Seok-Hwan Shin Kyung Rae Kim Ze-Hong Woo 

机构地区：[1]Department of Surgery,College of Medicine,Inha University,Incheon,Korea

出　　处：《World Journal of Gastroenterology》2008年第7期1102-1107,共6页世界胃肠病学杂志（英文版）

基　　金：Supported by Inha University Research Grant

摘　　要：AIM: To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct cancer.METHODS: A retrospective study was performed in 49 consecutive patients who underwent pancrea-ticoduodenectomy for distal common bile duct cancer. Potential risk factors were compared between the complicated and uncomplicated groups. Also, the rates of decrease in serum bilirubin were compared pre- and postoperatively. RESULTS: Preoperative biliary drainage (PBD) was performed in 40 patients (81.6%). Postoperative morbidity and mortality rates were 46.9% (23/49) and 6.1% (3/49), respectively. The presence or absence of PBD was not different between the complicated and uncomplicated groups. In patients with PBD, neither the absolute level nor the rate of decrease in serum bilirubin was significantly different. Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week (5.5 ± 4.4 μmol/L vs -1.7 ± 9.9 μmol/L, P = 0.004).CONCLUSION: PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer. There is a certain group of patients with a compromised hepatic excretory function, which is represented by the slow rate of decrease in serum bilirubin after PBD.AIM： To examine if the rate of decrease in serum bilirubin after preoperative biliary drainagecan be used as a predicting factor for surgical complications and postoperative recovery after pancreaticoduodenectomy in patients with distal common bile duct cancer.METHODS： A retrospective study was performed in 49 consecutive patients who underwent pancrea-ticoduodenectomy for distal common bile duct cancer. Potential risk factors were compared between the complicated and uncomplicated groups. Also, the rates of decrease in serum bilirubin were compared pre- and postoperatively. RESULTS： Preoperative biliary drainage （PBD） was performed in 40 patients （81.6%）. Postoperative morbidity and mortality rates were 46.9% （23/49） and 6.1% （3/49）, respectively. The presence or absence of PBD was not different between the complicated and uncomplicated groups. In patients with PBD, neither the absolute level nor the rate of decrease in serum bilirubin was significantly different. Patients with rapid decrease preoperatively showed faster decrease during the first postoperative week （5.5 ± 4.4 μmol/L vs -1.7 ± 9.9 μmol/L, P = 0.004）.CONCLUSION： PBD does not affect the surgical outcome of pancreaticoduodenectomy in patients with distal common bile duct cancer. There is a certain group of patients with a compromised hepatic excretory function, which is represented by the slow rate of decrease in serum bilirubin after PBD.

关 键 词：Distal bile duct cancer Drainage BILIRUBIN RATE 

分 类 号：R735.8[医药卫生—肿瘤]