The effect of biliary stents implanted before pancreaticoduodenectomy in periampullary tumors on postoperative results: a retrospective analysis of 106 consecutive cases at a single medical center

• Published in: Surgery today (Tokyo, Japan) Vol. 53; no. 4; pp. 499 - 506
• Main Authors: Özdemir, Yılmaz, Peksöz, Rıfat, Tör, İbrahim Hakkı, Fakirullahoğlu, Mesud, Temiz, Ayetullah, Kara, Salih, Binarbaşı, Cemil, Akgül, Gökhan Giray, Atamanalp, Sabri Selçuk
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-04-2023
• Subjects: Aged; Bilirubin; Drainage - adverse effects; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - adverse effects; Postoperative Complications - etiology; Preoperative Care - adverse effects; Retrospective Studies; Stents - adverse effects; Surgery; Surgical Oncology; Jaundice; Periampullary tumors; Preoperative biliary drainage; Pancreaticoduodenectomy; Postoperative outcomes
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02589-2

Purpose
The present study evaluated the potential effects of biliary drainage before pancreaticoduodenectomy on postoperative outcomes and presented the details of a surgeon’s 6 years of experience.
Methods
All consecutive pancreatoduodenectomies performed from 2015 to 2021 were retrospectively analyzed. The study population was divided into two groups: the stented group (Group I) and the nonstented group (Group II). Patient demographic data and clinical characteristics were compared between the two groups.
Results
This study comprised 106 individuals who underwent pancreaticoduodenectomy for periampullary tumors. The median age of the patients was 64.41 ± 11.67 years, and 65 (61.3%) were males. Sixty-seven patients (63.2%) received biliary drains (stented group), and 39 (36.8%) patients did not (nonstented group). Total bilirubin values (6.39 mg/dl) were higher in the nonstented patient group than in the stented group. The rate of total complications was significantly higher in the stented group than in the nonstented group [please check this carefully] (
p
 < 0.05). The length of stay, operation time and pancreatic fistula were found to be higher in the stented group than in the nonstented group.
Conclusions
Although the total bilirubin value was higher in the nonstented patient group than in the stented group, preoperative biliary drainage increased postoperative complication rates, operation time, and hospital stay. An advanced age and the presence of stents were independent risk factors influencing morbidity development according to the multivariate analysis
.