The influence of preoperative biliary drainage on the outcomes of pancreaticoduodenectomy procedure in a single center - a retrospective study

Background: Pancreaticoduodenectomy (PD) is a complex surgery that has the benefit of improving mortality but carries the risk of unfavorable postoperative outcomes, including surgical site infection (SSI). The goal of this study was to examine the relationship between SSI and other outcomes in relation to preoperative biliary drainage (PBD) in patients who had PD. Methodology: This study retrospectively included all patients in the university hospital who underwent PD between June 2014 and November 2022. Data were collected from the centre's database. Patients were divided into two groups according to whether they were drained. Results: A total of 70 patients were included. Most were males (43, 63.2%). Of all patients, 33 (47.1%) were drained before surgery. Twenty-four (34.3%) developed SSI. There was no difference in SSI between the drained and non-drained groups. On multivariate regression, SSI was independently associated with male sex (P = 0.041), lower body mass index (P < 0.05), and pancreatic tumors (0.029). In addition, 18 (25.7%) patients developed postoperative pancreatic fistula (POPF), and they were more likely to develop SSI (P = 0.005). Conclusion: Bile contamination was more common in drained patients, though with no association with SSI. Drained patients tend to have fewer leaks and hospitalizations. Therefore, PBD could help decrease the incidence of POPF.