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Effect of biliary decompression on morbidity and mortality of pancreatoduodenectomy
Authors:James H Thomas  Carol S Connor  George E Pierce  Richard I MacArthur  John I Iliopoulos  Arlo S Hermreck
Institution:Kansas City, Kansas, USA
Abstract:To evaluate the effect of levels of serum bilirubin on morbidity and mortality after pancreatoduodenectomy, a prospective study was designed to compare patients who underwent preoperative biliary decompression to those who did not. Preoperative biliary decompression decreased the mean serum bilirubin level from 15.8 to 5.8 mg/dl in one group of 10 patients (Group A). The only statistical differences between this group and the two other groups of patients (Groups B and C) who were not treated with preoperative biliary decompression was the level of serum bilirubin before pancreatoduodenectomy (5.8, 22, and 1.3 mg/dl in Groups A, B, and C, respectively). Only one death occurred in each group of patients. The numbers of nonfatal complications were comparable. These results suggest that there is no decrease in morbidity or mortality after pancreatoduodenectomy when the serum bilirubin level is decreased by preoperative biliary drainage.
Keywords:Requests for reprints should be addressed to James H  Thomas  MD  Department of Surgery  University of Kansas Medical Center  39th and Rainbow Boulevard  Kansas City  Kansas 66103  
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