Biliary drainage;
Pancreaticoduodenectomy;
Postoperative complication;
POSTOPERATIVE PANCREATIC FISTULA;
BILE JUICE INFECTION;
RISK-FACTORS;
COMPLICATIONS;
MORBIDITY;
INCREASES;
IMPACT;
BACTEROBILIA;
CHOLANGITIS;
SURGEON;
D O I:
10.1016/j.pan.2019.06.013
中图分类号:
R57 [消化系及腹部疾病];
学科分类号:
摘要:
Background/Objectives: The aims of this study were to clarify the effect of preoperative biliary drainage (PBD) on postoperative outcomes and the role of preoperative intentional exchange from endoscopic nasobiliary drainage (ENBD) to endoscopic retrograde biliary drainage (ERBD) for patients waiting to undergo pancreaticoduodenectomy (PD). Methods: We evaluated the effect of PBD and intentional exchange of PBD on the perioperative variables in 292 patients. Results: A total of 179 (61.3%) of 292 patients received PBD. There was no marked difference in the postoperative outcomes between the patients who did and did not receive PBD. Among the 160 patients who initially received endoscopic PBD, 10 (6.3%) underwent stent exchange for stent dysfunction, 59 (36.9%) who did not develop stent dysfunction underwent intentional stent exchange from ENBD to ERBD (bridge PBD group), and 91 (56.9%) did not receive any stent exchange (unchanged PBD group). The bridge PBD group had a longer duration of PBD (37 days) (p <0.001) and a shorter preoperative hospital stay after PBD (32 days) (p <0.001) than the unchanged PBD group (25 and 46 days, respectively); however, there were no significant differences in the postoperative variables. The incidence of stent exchange due to stent dysfunction in the bridge PBD group (11.9%) was lower than that in patients who initially received ERBD (36.0%) (p = 0.015). Conclusions: Bridge PBD worked well for extending the duration of PBD without worsening the postoperative outcomes after PD. (C) 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.
机构:
Sichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R ChinaSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Xiong, Jun-Jie
Nunes, Quentin M.
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机构:
Univ Liverpool, Royal Liverpool Univ Hosp, Dept Mol & Clin Canc Med, NIHR Liverpool Pancreas Biomed Res Unit, Liverpool, Merseyside L69 3GA, EnglandSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Nunes, Quentin M.
Huang, Wei
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h-index: 0
机构:
Sichuan Univ, West China Hosp, Sichuan Prov Pancreatitis Ctr, Dept Integrated Tradit Chinese & Western Med, Chengdu 610041, Sichuan, Peoples R ChinaSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Huang, Wei
Pathak, Samir
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机构:
St James Univ Hosp, Dept Hepatobiliary & Transplant Surg, Leeds LS9 7TF, W Yorkshire, EnglandSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Pathak, Samir
Wei, Ai-Lin
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机构:
Sichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R ChinaSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Wei, Ai-Lin
Tan, Chun-Lu
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机构:
Sichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R ChinaSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
Tan, Chun-Lu
Liu, Xu-Bao
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h-index: 0
机构:
Sichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R ChinaSichuan Univ, West China Hosp, Dept Hepatobiliary Pancreat Surg, Chengdu 610041, Sichuan Provinc, Peoples R China
机构:
Department of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan UniversityDepartment of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan University
Jun-Jie Xiong
Quentin M Nunes
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h-index: 0
机构:
NIHR Liverpool Pancreas Biomedical Research Unit,Department of Molecular and Clinical Cancer Medicine,Royal Liverpool University Hospital,University of LiverpoolDepartment of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan University
Quentin M Nunes
Wei Huang
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h-index: 0
机构:
Sichuan Provincial Pancreatitis Center,Department of Integrated Traditional Chinese and Western Medicine,West China Hospital,Sichuan UniversityDepartment of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan University
Wei Huang
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机构:
Samir Pathak
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Ai-Lin Wei
Chun-Lu Tan
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机构:
Department of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan UniversityDepartment of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan University
Chun-Lu Tan
Xu-Bao Liu
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h-index: 0
机构:
Department of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan UniversityDepartment of Hepato-Biliary-Pancreatic Surgery,West China Hospital,Sichuan University
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Nankai Univ, Sch Med, Tianjin 300071, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Huang, Xin
Liang, Bin
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Liang, Bin
Zhao, Xiang-Qian
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h-index: 0
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Zhao, Xiang-Qian
Zhang, Fu-Bo
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h-index: 0
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Nankai Univ, Sch Med, Tianjin 300071, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Zhang, Fu-Bo
Wang, Xi-Tao
论文数: 0引用数: 0
h-index: 0
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Nankai Univ, Sch Med, Tianjin 300071, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China
Wang, Xi-Tao
Dong, Jia-Hong
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h-index: 0
机构:
Chinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R ChinaChinese Peoples Liberat Army Gen Hosp, Dept & Inst Hepatobiliary Surg, Beijing 100853, Peoples R China