Impact of Preoperative Endoscopic Biliary Drainage on Postoperative Outcome after Pancreaticoduodenectomy

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Background: The value of preoperative biliary drainage (PBD) on the surgical outcome after pancreaticoduodenectomy (PD) is still a point of controversy.The aim of this study was to identify the impact of biliary drainage (BD) prior to PD on the postoperative outcome.Methods: The data of patients, who underwent PD from February 2009 to February 2017, were retrospectively studied.A comparison was performed between 2 groups of patients; group A (with PBD) and group B (without PBD), according to preoperative, operative and postoperative data.Results: PD was performed in 158 patients with periampullary lesions.Group A, included 76 patients (48.1%) while 82 patients were included in group B (51.9%).The incidence of major postoperative complications was significantly higher in group A (P=0.04).The infectious complications were higher in group like; positive intraoperative bile culture (P=0.06), intraabdominal abscess (P=0.07) and wound infection (P=0.04).Also, hospital stay and mortality were higher in group A (P=0.05 and 0.08, respectively).High preoperative bilirubin level was not a risk factor for major postoperative complications (P=0.12).Conclusion: Patients with PBD had a significantly higher incidence of major postoperative complications mainly of infectious ones, thus PBD should be performed only in selected patients, not as a routine prior PD.

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