Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy

作者：Palepu Jagannath, Vinay K. Dhir, S. S. Shrikhande, Rajiv C. Shah, Prashant M. Mullerpatan, K M Mohandas · 发表于：British journal of surgery · 年份：2005 · DOI：10.1002/bjs.4864 · 被引用次数：208 · 研究领域：Gallbladder and Bile Duct Disorders、Pancreatic and Hepatic Oncology Research、Esophageal and GI Pathology

BACKGROUND: Preoperative biliary stenting is associated with bacterial contamination of bile and an increased rate of infectious complications after pancreaticoduodenectomy. Preoperative drainage has been found to have conflicting effects on morbidity and mortality, and no studies have been published on the effect of stent complications and duration of stenting on postoperative outcome. This study examined the effects of preoperative biliary stenting on early outcome after pancreaticoduodenectomy. METHODS: Details of 144 patients undergoing pancreaticoduodenectomy from 1992 to 2001 were entered into a database. Variables included biliary stenting, duration of stenting, stent complications and bile culture results. Details of surgery and postoperative complications were noted. Patients were grouped as stented and non-stented. Factors likely to affect postoperative mortality and morbidity were analysed. RESULTS: Preoperative biliary stenting was performed in 74 of the 144 patients; post-stenting complications developed in 18 patients (24 per cent) before surgery. After surgery there were nine deaths (6.3 per cent) and 60 (41.7 per cent) of the 144 patients developed complications, with no significant difference in morbidity rate between stented and non-stented patients. Logistic regression showed that a positive intraoperative bile culture was the only factor significantly associated with operative morbidity (P < 0.001) and mortality (P = 0.019). Biliary stenting was not signif...