Impact of internal biliary drainage after pancreaticoduodenectomy.
BACKGROUND
Bile acid has an important role in protecting immune systems related to gut-associated lymphoid tissue. This study was designed to evaluate the effects of internal biliary drainage after a pancreaticoduodenectomy (PD) on postoperative nutrition and complications in a randomized study.


METHODS
The authors compared the morbidity, mortality, and postoperative nutritional status of 46 patients who had a hepaticojejunostomy (HJ) with a stented external biliary drainage (group E) or with a non-stented internal biliary drainage (group I) after a PD.


RESULTS
Systemic infection was recognized in four patients in group E, while no patients in group I. Transthyretin at postoperative 28 days in group I was 15.6 +/- 6.2, higher than that in group E. Retinol-binding protein at postoperative 28 days in group I was 2.6 +/- 1.0 and also higher than that in group E.


CONCLUSIONS
HJ with no-stented internal biliary drainage was not associated with systemic infections and mortality, but showed the possibility of improving nutritional status.
Fujino
Yasuhiro
Y
Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. yasu120@hp.pref.hyogo.jp
Matsumoto
Ippei
I
Shinzeki
Makoto
M
Ajiki
Tetsuo
T
Kuroda
Yoshikazu
Y
D000368:Aged; D001647:Bile Acids and Salts / Q000502:physiology*; D001650:Bile Duct Neoplasms / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D004379:Duodenal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D018709:Statistics, Nonparametric; D015607:Stents; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
D001647:Bile Acids and Salts