Resumen
Background – Pancreaticoduodenectomy is the procedure of
choice for the treatment of resectable pancreaticoduodenal tumours. It
has been proposed that jaundice is associated with worse outcomes,
but the usefulness of preoperative biliary drainage in these patients is
still controversial. Methods – Retrospective cohort study of patients undergoing
Whipple procedure at the Hospital Universitario San Ignacio,
Bogotá (Colombia), between January 2010 and June 2023. The cohort
of patients who underwent preoperative biliary drainage was compared
with those who went directly operated on. Comorbidities, functional status
and procedural characteristics were recorded. The outcomes, including
mortality and intraoperative and 30-day postoperative complications,
were compared between groups. Results – A total of 98 patients were
included, 49 of whom underwent preoperative biliary drainage. In this
group, there was a higher proportion of patients with pathological stage
II and III disease (77.5 vs 49.0, P=0.04) and higher preoperative bilirubin
levels (median 6.4 vs 4.9 mg/dL; P=0.02). There were no differences in
intraoperative (10.2% vs 14.3%; P=0.34) or postoperative (61.2% vs 51%;
P=0.15) complications, but 30-day mortality was higher in patients with
biliary drainage (8.2 vs 20.4%; P=0.03). Conclusion – Our data suggest
that there are no differences in postoperative complications. The
higher mortality rate in patients with preoperative biliary drainage may
be related to differences in baseline patient characteristics and/or delays
between biliary drainage and Whipple procedure.
choice for the treatment of resectable pancreaticoduodenal tumours. It
has been proposed that jaundice is associated with worse outcomes,
but the usefulness of preoperative biliary drainage in these patients is
still controversial. Methods – Retrospective cohort study of patients undergoing
Whipple procedure at the Hospital Universitario San Ignacio,
Bogotá (Colombia), between January 2010 and June 2023. The cohort
of patients who underwent preoperative biliary drainage was compared
with those who went directly operated on. Comorbidities, functional status
and procedural characteristics were recorded. The outcomes, including
mortality and intraoperative and 30-day postoperative complications,
were compared between groups. Results – A total of 98 patients were
included, 49 of whom underwent preoperative biliary drainage. In this
group, there was a higher proportion of patients with pathological stage
II and III disease (77.5 vs 49.0, P=0.04) and higher preoperative bilirubin
levels (median 6.4 vs 4.9 mg/dL; P=0.02). There were no differences in
intraoperative (10.2% vs 14.3%; P=0.34) or postoperative (61.2% vs 51%;
P=0.15) complications, but 30-day mortality was higher in patients with
biliary drainage (8.2 vs 20.4%; P=0.03). Conclusion – Our data suggest
that there are no differences in postoperative complications. The
higher mortality rate in patients with preoperative biliary drainage may
be related to differences in baseline patient characteristics and/or delays
between biliary drainage and Whipple procedure.
| Idioma original | Inglés |
|---|---|
| Número de artículo | e24089 |
| Número de páginas | 10 |
| Publicación | Arquivos de Gastroenterologia |
| Volumen | 62 |
| DOI | |
| Estado | Publicada - 21 jul. 2025 |
Palabras clave
- Drainage; adverse effects; choangiopancreatography; endoscopic retrograde; pancreaticoduodenectomy; jaundice; obstructive; etiology; pancreatic neoplasms; common bile duct neoplasms; preoperative care.