Complications of pancreaticoduodenectomy after neoadjuvant chemoradiation in patients with and without preoperative biliary drainage

被引:26
|
作者
Gerke, H [1 ]
White, R
Byrne, MF
Stiffler, H
Mitchell, RM
Hurwitz, HI
Morse, MA
Branch, MS
Jowell, PS
Czito, B
Clary, B
Pappas, TN
Tyler, DS
Baillie, J
机构
[1] Duke Univ, Med Ctr, Dept Med, Div Gastroenterol, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Dept Med, Div Hematol Oncol, Durham, NC 27710 USA
[3] Duke Univ, Med Ctr, Dept Surg, Durham, NC 27710 USA
[4] Duke Univ, Med Ctr, Dept Radiat Oncol, Durham, NC 27710 USA
关键词
cholangiopancreatography; endoscopic retrograded jaundice; neoadjuvant therapy; pancreatic neoplasms; pancreaticoduodenectomy;
D O I
10.1016/j.dld.2004.01.024
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. It has been suggested that preoperative biliary drainage increases the risk of infectious complications of pancreaticoduodenectomy. Aims. The aim of this study was to assess complications related to biliary stents/drains and postoperative morbidity in patients undergoing neoadjuvant chemoradiotherapy for periampullary cancer. Patients. One hundred and eighty-four patients with periampullary neoplasms were prospectively selected for neoadjuvant external beam radiation therapy and 5-fluorouracil-based chemotherapy between 1995 and 2002. Methods. The data were retrospectively completed and analysed with respect to biliary drainage, efficacy and complications of endoscopic biliary stents and postoperative morbidity. Patients who had undergone a surgical biliary bypass were excluded. Results. Data were completed in 168 patients. One hundred and nineteen patients were treated with endoscopic biliary stents, 18 patients had a percutaneous biliary drain and 31 patients did not require biliary drainage. Hospitalisation for stent-related complications was necessary in 15% of the patients with endoscopic biliary stents. Seventy-two patients underwent pancreaticoduodenectomy. There was no significant difference in the rate of wound infections, intra-abdominal abscesses and overall complications between the groups with and without preoperative biliary drainage. Conclusions. Postoperative infectious complications are common in patients both with and without preoperative biliary drainage. A statistically significant difference in complication rates was not observed between these groups. (C) 2004 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:412 / 418
页数:7
相关论文
共 50 条
  • [1] The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy
    Sewnath, ME
    Birjmohun, RS
    Gouma, DJ
    [J]. GASTROINTESTINAL ENDOSCOPY, 1999, 49 (04) : AB236 - AB236
  • [2] The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy
    Sewnath, ME
    Birjmohun, RS
    Rauws, EAJ
    Huibregtse, K
    Obertop, H
    Gouma, DJ
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2001, 192 (06) : 726 - 734
  • [3] Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy?
    Tortajada, Pauline
    Sauvanet, Alain
    Truant, Stephanie
    Regenet, Nicolas
    Souche, Regis
    Benoist, Stephane
    Muscari, Fabrice
    Regimbeau, Jean Marc
    Gaujoux, Sebastien
    Cunha, Antonio Sa
    Schwarz, Lillian
    [J]. CANCERS, 2020, 12 (10) : 1 - 12
  • [4] Preoperative biliary drainage before pancreaticoduodenectomy increases postoperative complications
    Kausar, A.
    Tomkow, L.
    Deshpande, R.
    Sherlock, D.
    O'Reilly, D.
    [J]. BRITISH JOURNAL OF SURGERY, 2010, 97 : 185 - 185
  • [5] Adequate Preoperative Biliary Drainage Is Determinative to Decrease Postoperative Infectious Complications after Pancreaticoduodenectomy
    Lin, Shao-Chieh
    Shan, Yan-Shen
    Lin, Pin-Wen
    [J]. HEPATO-GASTROENTEROLOGY, 2010, 57 (101) : 698 - 705
  • [6] Preoperative Biliary Drainage and Surgical Outcome After Pancreaticoduodenectomy
    di Mola, F. F.
    Tavano, F.
    De Bonis, A.
    Grottola, T.
    Tardio, M.
    Valvano, M. R.
    Andriulli, A.
    di Sebastiano, P.
    [J]. PANCREAS, 2012, 41 (08) : 1355 - 1356
  • [7] Clinical impact of preoperative biliary drainage on postoperataive complications in pancreaticoduodenectomy.
    Okabe, Hirohisa
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (04)
  • [8] The Effects of Different Preoperative Biliary Drainage Methods on Complications Following Pancreaticoduodenectomy
    Huang, Xin
    Liang, Bin
    Zhao, Xiang-Qian
    Zhang, Fu-Bo
    Wang, Xi-Tao
    Dong, Jia-Hong
    [J]. MEDICINE, 2015, 94 (14)
  • [9] Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage
    Han, Sang Hyup
    Kim, Joo Seop
    Hwang, Ji Woong
    Kim, Hae Sung
    [J]. GLAND SURGERY, 2021, 10 (05) : 1669 - 1676
  • [10] Preoperative cholangitis during biliary drainage increases the incidence of postoperative severe complications after pancreaticoduodenectomy
    Kitahata, Yuji
    Kawai, Manabu
    Tani, Masaji
    Hirono, Seiko
    Okada, Ken-ichi
    Miyazawa, Motoki
    Shimizu, Atsushi
    Yamaue, Hiroki
    [J]. AMERICAN JOURNAL OF SURGERY, 2014, 208 (01): : 1 - 10