The aim of this study was to assess the risk and complications after preoperative drainage of biliary obstruction in patients who underwent pancreatoduodenectomy. A retrospective cohort study of all patients who underwent pancreatoduodenectomy from January 1st, 2015 to September 30th, 2021. Patients who had preoperative bile duct drainage were compared to patients without intervention. Type of interventions, complications and outcome after surgery were compared using univariate and multivariate analysis.
Obstructive jaundice is a common problem in pancreatic and periampullary tumors, but preoperative biliary drainage in patients with hyperbilirubinemia is still controversial. The aim of this retrospective cohort study was to assess the risk and complications after preoperative drainage of biliary obstruction in patients who underwent pancreatoduodenectomy. A retrospective cohort study of all patients who underwent pancreatoduodenectomy from January 1st, 2015 to September 30th, 2021.
Study Type
OBSERVATIONAL
Enrollment
722
Placement of biliary stent (plastic, covered SEMS, uncovered SEMS) endoscopic by ERC or placement of plastic catheter by PTC
Rigshospitalet
Copenhagen, Capitol, Denmark
Post-operative complication score (Clavien-Dindo)
The prevalence of complications graded according to Clavien-Dindo score after pancreatoduodenectomy. Clavien-Dindo 0 is no complications, Clavien-Dindo 5 means complications resulting in mortality.
Time frame: During hospital admission, median time 13 days, up to 390 days.
30-day Mortality
30-day mortality rate post-pancreatoduodenectomy
Time frame: up to 30 days
90-day Mortality
90-day mortality rate post-pancreatoduodenectomy
Time frame: up to 90 days
Length of Hospital Stay
Accumulated length of hospital stay from the admission day prior to pancreatoduodenectomy, till the day of discharge.
Time frame: Days from admission until discharge, up to 390 days, median time 13 days
30-day Readmission
Prevalence of readmission within 30-days after discharge following pancreatoduodenectomy.
Time frame: up to 30-days from hospital discharge
Complications following preoperative bile duct drainage
Prevalence of cholangitis, pancreatitis, iatrogenic perforation, post-procedural bleeding and post-procedural thrombosis
Time frame: up to 7 days after bile duct drainage
Time from Bile Duct Drainage to Pancreatoduodenectomy
Time from Bile Duct Decompression to pancreatoduodenectomy.
Time frame: Days from bile duct decompression to pancreatoduodenectomy, median time 32 days, up to 534 days
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Histological Specimen
Histological diagnosis of the resection specimens divided in malignant (ductal adenocarcinoma, cholangiocarcinoma, papillary carcinoma, duodenal adenocarcinoma, neuroendocrine tumor, other pancreatic carcinoma, other malignancy in the pancreas) and benign (IPMN, other benign diseases).
Time frame: Obtained within 21 days after resection