Objective: To assess the influence of jaundice and preoperative biliary drainage (PBD) on postoperative outcome following pancreaticoduodenectomy (PD).
Material and methods: Data of 122 patients who underwent PD for periampular tumors and pancreatic adenocarcinoma in Kaunas University of Medicine Hospital was analyzed. Patients were divided into groups: those who have not underwent PBD, but had preoperative bilirubin level <50 micromol/l (n=42), patients without PBD, but preoperative bilirubin exceeding 50 micromol/l (n=61) and patients who have undergone preoperative PBD (n=19).
Results: Overall morbidity following PD was 55.6%. There were 10.7% pancreatic fistulas, 13.1% septic complications (either intraabdominal sepsis or wound infection) and 9% of postoperative intraabdominal bleeding. Postoperative mortality was 9.8%. There was no statistically significant difference in either overall morbidity, pancreatic fistula rates, septic complications, bleeding or postoperative mortality between jaundiced and nonjaundiced patients. Preoperative bilirubinemia in patients without PBD and without postoperative complications did not significantly differ from those without PBD who developed complications. Overall morbidity, pancreatic fistula rate, septic complications, bleeding, postoperative mortality were similar in PBD and nonPBD groups as well as in stented and nonstented patients.
Conclusions: As obstructive jaundice has no impact on postoperative results of PD. PBD or stenting of bile ducts should not be used routinely and is justified in cases when surgery with intent for cure has to be postponed.