Publication: Effects of preoperative drainage on postoperative complications in patients with periampullary tumors
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Date
2019
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Abstract
Aim: Preoperative biliary drainage is suggested for patients with jaundice, considering that surgical operations may increasepostoperative complications in the presence of jaundice. The aim of this study was to test the effect of biliary drainage on possibleserious complications, deaths, or period of hospital stay.Material and Methods: Between January 2012 and June 2016, 160 patients with operable and resectable periampullary tumorswho were diagnosed with periampullary tumors underwent pancreaticoduodenectomy (Whipple’s procedure) in Marmara UniversityPendik Training and Research Hospital, Department of General Surgery. The patients’ demographics, accompanying comorbiddiseases, type of biliary drainage, drainage duration, pre- and post-drainage laboratory data, emerging complications and need forre-hospitalization were recorded retrospectively from the accessible files and records.Results: It was observed that out of 158 patients with periampullary tumors, 116 that were operated with drainage had a higheroccurrence of surgical site infections and anastomotic leaks, compared to the 42 patients that were operated without drainage.Similarly, when patient results were classified according to the Clavien-Dindo complication classification, the ratio was againagainst the patients that were operated with drainage. Drainage patients stayed in the hospital for a longer period; however, in termsof pancreatic fistula, re-hospitalization, need for intensive care and relaparotomy ratios, and especially in terms of mortality ratios, adifference between two patient groups was not observed.Conclusion: Investigating the data collected from patients that were operated without drainage, and specifically considering thebilirubin values of the patients who had complications, there was no threshold identified that contributed to a higher likeliness ofcomplications. Consequently, even though there were no results to motivate recommending drainage, it was concluded that applyingdrainage does not create any difference in short-term prognosis, but drainage increases infectious complications.
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Biyoloji, Diş Hekimliği, Alerji, Anatomi ve Morfoloji, Androloji, Anestezi, Odyoloji ve Konuşma-Dil Patolojisi, Biyokimya ve Moleküler Biyoloji, Biyofizik, Biyoteknoloji ve Uygulamalı Mikrobiyoloji, Kalp ve Kalp Damar Sistemi, Hücre Biyolojisi, Klinik Nöroloji, Yoğun Bakım, Tıp, Dermatoloji, Acil Tıp, Endokrinoloji ve Metabolizma, Gastroenteroloji ve Hepatoloji, Geriatri ve Gerontoloji, Sağlık Bilimleri ve Hizmetleri, Hematoloji, İmmünoloji, Enfeksiyon Hastalıkları, Tamamlayıcı ve Entegre Tıp, Tıbbi Etik, Tıbbi İnformatik, Tıbbi Laboratuar Teknolojisi, Genel ve Dahili Tıp, Adli Tıp, Tıbbi Araştırmalar Deneysel, Mikrobiyoloji, Nörolojik Bilimler, Kadın Hastalıkları ve Doğum, Onkoloji, Göz Hastalıkları, Ortopedi, Kulak, Burun, Boğaz, Patoloji, Pediatri, Periferik Damar Hastalıkları, Fizyoloji, Temel Sağlık Hizmetleri, Psikiyatri, Halk ve Çevre Sağlığı, Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme, Rehabilitasyon, Solunum Sistemi, Romatoloji, Spor Bilimleri, Cerrahi, Transplantasyon, Tropik Tıp, Üroloji ve Nefroloji, Farmakoloji ve Eczacılık, Toksikoloji