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Impact of Preoperative Biliary Drainage on Surgical Outcomes in Periampullary and Hilar Malignancy: A Single-Center Experience

Ito, Yukiko MD, PhD; Nakai, Yousuke MD, PhD; Isayama, Hiroyuki MD, PhD; Tsujino, Takeshi MD, PhD; Hamada, Tsuyoshi MD, PhD; Umefune, Gyotane MD; Akiyama, Dai MD, PhD; Takagi, Kaoru MD; Takamoto, Takeshi MD, PhD; Hashimoto, Takuya MD, PhD; Nakata, Ryo MD, PhD; Koike, Kazuhiko MD, PhD; Makuuchi, Masatoshi MD, PhD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: April 2016 - Volume 26 - Issue 2 - p 150–155
doi: 10.1097/SLE.0000000000000252
Original Articles
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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.

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

The authors declare no conflicts of interest.

Reprints: Yousuke Nakai, MD, PhD, Department of Gastroenterology, Japanese Red Cross Medical Center, 4-1-22 Hiroo Shibuya-ku, Tokyo, Japan 150-8935 (e-mail: ynakai-tky@umin.ac.jp).

Received May 22, 2015

Accepted December 21, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.