Intraoperative Biliary Drainage in Pancreaticoduodenectomy

AIM: It is generally accepted that preoperative biliarydrainage (PBD) in preventing the operative complications afterpancreaticoduodenectomy (PD) in patients with deeply obstructivejaundice. However, whether PBD is beneficial in reducingcomplications after PD is still controversial. In this study, wecompared the influence of with or without intraoperative biliarydrainage (IBD) for decreasing the incidence of complication in PDwithout PBD.METHODS: We retrospectively analyzed 40 patients who underwentPD without PBD with preoperative serum bilirubin level <5 mg/dL,either with IBD (IBD group) or without IBD (NIBD group).RESULTS: The serum level of bilirubin at the 7 d after the surgerywas significantly higher in the NIBD group than in the IBD group(p<0.0176). However, no differences were observed between the 2groups with respect to the serum level of AST, ALT, γ-GTP, and ALPat the 7 d after the surgery. There were no significant differences inpostoperative complications between the 2 groups.CONCLUSIONS: We consider IBD is useful to prevent postoperativeliver damage; however, there is no significant differences in terms ofpostoperative complications with or without IBD in PD without PBDwith preoperative serum bilirubin level <5 mg/dL.