Effect of biliary drainage methods on patients with obstructive jaundice undergoing pancreaticoduodenectomy

Abstract

Objective To explore the impact of preoperative biliary drainage methods on perioperative complications. Methods Clinical data of 448 patients of malignant distal biliary obstruction with jaundice who underwent pancreaticoduodenectomy and received preoperative biliary drainage were collected from January 2012 to December 2019. Among them, 238 patients received percutaneous transhepatic cholangial drainage(PTCD) as PTCD group and 210 patients received endoscopic retrograde cholangiopancreatography (ERCP) as ERCP group, including 101 cases with endoscopic biliary sten-ting (EBS) as EBS group and 109 cases with endoscopic nasobiliary drainage. The intervention unsuccess rate and perio-perative complications of different biliary drainage methods were analyzed. Results Intervention unsuccess rate of ERCP was higher than that of PTCD (P=0.034). Postoperative pancreatic fistula rate and reoperation rate were higher in ERCP group than those in PTCD group, respectively (P=0.005 and P=0.025). In analysis of subgroup, overall postoperative complication rate in EBS group was higher than that in PTCD group (P=0.014), and pancreatic fistula rate and reoperation rate in EBS group were higher than those in PTCD group (P<0.001 and P=0.041). There was no statistical difference in other complications between groups. Conclusions PTCD could be used as biliary drainage method with greater advantage than ERCP for the patients of malignant distal biliary obstruction with jaundice before pancreaticoduodenectomy.

Keywords

• |obstructive jaundice|biliary drainage|percutaneous transhepatic cholangial drainage|endoscopic retrograde cholangiopancreatography|endoscopic biliary stenting