title: Impact of Preoperative Biliary Drainage on Surgical Outcomes in Periampullary and Hilar Malignancy: A Single-Center Experience.
abstract: The role of preoperative biliary drainage (PBD) for periampullary and hilar malignancy is still controversial. We retrospectively studied consecutive 144 patients (92 periampullary and 52 hilar malignancy) undergoing surgical resection to evaluate the effects of PBD on surgical outcomes. The rate of PBD was 59% and 56%, and postoperative complications developed in 27% and 19% in periampullary and hilar malignancy, respectively. Risk factors for postoperative complications were overweight [odds ratio (OR), 7.6] and depression (OR, 8.5) in distal malignancy and American society of anesthesiologists score of 3 (OR, 6.6), depression (OR, 13.8), and portal vein embolization (OR, 6.1) in hilar malignancy. PBD was not associated with postoperative complications but reinterventions for PBD were necessary in 43% and 27% in distal and hilar biliary obstruction. In conclusion, PBD in pancreatobiliary surgery was not associated with postoperative complications, but the improvement of PBD is necessary given the high rate of reinterventions.
authors: Departments of *Gastroenterology ‡Hepato-Biliary-Pancreatic-Transplantation Surgery, Japanese Red Cross Medical Center †Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Yukiko
authors: Y
authors: Ito
authors: Yousuke
authors: Y
authors: Nakai
authors: Hiroyuki
authors: H
authors: Isayama
authors: Takeshi
authors: T
authors: Tsujino
authors: Tsuyoshi
authors: T
authors: Hamada
authors: Gyotane
authors: G
authors: Umefune
authors: Dai
authors: D
authors: Akiyama
authors: Kaoru
authors: K
authors: Takagi
authors: Takeshi
authors: T
authors: Takamoto
authors: Takuya
authors: T
authors: Hashimoto
authors: Ryo
authors: R
authors: Nakata
authors: Kazuhiko
authors: K
authors: Koike
authors: Masatoshi
authors: M
authors: Makuuchi
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D041781:Jaundice, Obstructive / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010180:Pancreatectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends