Correlations between the Rate of Decrease in Preoperative Bilirubin and Postoperative Complications after Biliary Drainage for Distal Common Bile Duct Cancer.
- Author:
Eung Ho CHO
1
;
Keon Young LEE
;
Sun Keun CHOI
;
Yoon Seok HUR
;
Sei Joong KIM
;
Young Up CHO
;
Seung Ik AHN
;
Kee Chun HONG
;
Seok Hwan SHIN
;
Kyung Rae KIM
;
Ze Hong WOO
Author Information
1. Department of Surgery, Inha University College of Medicine, Incheon, Korea. 196087@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Drainage;
Bilirubin;
Rate;
Pancreaticoduodenectomy
- MeSH:
Bilirubin*;
Common Bile Duct*;
Drainage*;
Humans;
Liver;
Mortality;
Pancreaticoduodenectomy;
Postoperative Complications*;
Postoperative Period
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2005;9(1):44-48
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was aimed at comparing the rate of decrease in preoperative serum bilirubin after biliary drainage and the postoperative complication rate in patients with distal common bile duct (CBD) cancer. METHODS: Forty six patients who had undergone pancreaticoduodenectomy due to distal CBD cancer were included in this study. The patients were divided into the complicated and uncomplicated groups. For the patients who underwent preoperative biliary drainage, the preoperative bilirubin level and the rate of decrease in serum bilirubin were measured and compared between the two groups. RESULTS: The postoperative complication and mortality rates were 43.4% (20/46) and 6.5% (3/46), respectively. The complication rates were not different between the drainage and non-drainage groups (p=0.48). The preoperative serum bilirubin levels were also not different between the complicated and uncomplicated groups (p=0.214). In the uncomplicated group, the rate of decrease in the serum total bilirubin level tended to be higher than in the complicated group, but this was not statistically significant (mean: 0.82 vs 0.27 mg/dl/day, respectively, p=0.117). Patients with a higher preoperative bilirubin decrease rate showed a larger bilirubin decrease in the immediate postoperative period (from POD 1 to POD 7, r=0.371, p=0.05). CONCLUSION: The preoperative biliary drainage and the serum bilirubin level were not correlated with the postoperative complication rate. Patients with higher preoperative bilirubin decrease rates showed a larger bilirubin decrease in the immediate postoperative period, which can be interpreted as having a faster recovery of their liver function. Further study with a larger number of cases is required to see if the preoperative bilirubin decrease rate could be used as a prognostic indicator after pancreaticoduodenectomy.
