title: Acute Pancreatitis After Percutaneous Biliary Drainage: An Obstacle in Liver Surgery for Proximal Biliary Cancer.
abstract: Percutaneous transhepatic biliary drainage (PTBD) has a crucial role in treatment of proximal biliary cancer (PBC). We assessed the incidence, risk factors, and impact of acute pancreatitis (AP) post-PTBD.
  
  
  
  Forty patients with PBC scheduled for PTBD from January 2005 to December 2015 were enrolled. Exclusion criteria were missing clinical data, PTBD performed in other institutions, and palliative PTBD.
  
  
  
  The 40 patients comprised 8 (20%) with gallbladder cancer, 6 (15%) with intrahepatic cholangiocarcinoma, and 26 (65%) with perihilar cholangiocarcinoma. A median of 1 PTBD procedure was performed per patient; 16 (40%) patients underwent PTBD more than once. PTBD was left-sided in 14 (35.0%) patients, right-sided in 21 (52.5%), and bilobar in 5(12.5%). Seventeen (42.5%) patients had one or more drainage-related complications. Five (12.5%) patients developed AP. A significantly higher percentage of patients with than without AP developed sepsis (60.0 vs. 11.4%, respectively) and did not undergo the planned liver resection [2 (40.0%) vs. 0 (0.0%), respectively]. Significantly more patients with than without AP underwent left-sided PTBD [10 (28.6%) vs. 4 (80.0%), respectively].
  
  
  
  PTBD is frequently complicated by AP. AP plays a key role in the development of sepsis. Nearly half of patients with AP lose the opportunity for surgical treatment.
authors.affiliation: Department of General and Oncological Surgery, Mauriziano Hospital "Umberto I", Largo Turati, 62, 10128, Turin, Italy. nrussolillo@mauriziano.it.
authors.forename: Nadia
authors.initials: N
authors.lastname: Russolillo
authors.affiliation: Department of General and Oncological Surgery, Mauriziano Hospital "Umberto I", Largo Turati, 62, 10128, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Massobrio
authors.affiliation: Department of General and Oncological Surgery, Mauriziano Hospital "Umberto I", Largo Turati, 62, 10128, Turin, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Langella
authors.affiliation: Department of General and Oncological Surgery, Mauriziano Hospital "Umberto I", Largo Turati, 62, 10128, Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lo Tesoriere
authors.affiliation: Department of Interventional Radiology, Mauriziano Hospital "Umberto I", Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Carbonatto
authors.affiliation: Department of General and Oncological Surgery, Mauriziano Hospital "Umberto I", Largo Turati, 62, 10128, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ferrero
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D018285:Klatskin Tumor / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology*