| 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 |
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| 作者姓名： | Choi YM Cho EH Lee KY Ahn SI Choi SK Kim SJ Hur YS Cho YU Hong KC Shin SH Kim KR Woo ZH |
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| 作者单位： | Department of Surgery College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea,Department of Surgery,College of Medicine,Inha University,Incheon,Korea |
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| 基金项目： | Supported by Inha University Research Grant |
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| 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.
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| 关 键 词： | 胆红素 胆管癌 手术治疗 胰十二指肠切除术 |
| 收稿时间： | 2007 Sep 9 |
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 |
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| Choi YM,Cho EH,Lee KY,Ahn SI,Choi SK,Kim SJ,Hur YS,Cho YU,Hong KC,Shin SH,Kim KR,Woo ZH.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[J].World Journal of Gastroenterology,2008,14(7):1102-1107. |
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| Authors: | Choi Yun Mee Cho Eung-Ho Lee Keon-Young Ahn Seung-Ik Choi Sun Keun Kim Sei Joong Hur Yoon Seok Cho Young Up Hong Kee Chun Shin Seok Hwan Kim Kyung Rae Woo Ze-Hong |
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| Institution: | Department of Surgery,College of Medicine,Inha University,Incheon,Korea |
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| Abstract: | 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 pancreaticoduodenectomy 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±9.9μmol/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. |
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| Keywords: | Distal bile duct cancer Drainage Bilirubin Rate |
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