Biliary Fistula, Pancreas Cancer, Surgery-Complications
Conditions
Keywords
pancreatoduodenectomy, complications, percutaneous transhepatic biliary drainage
Brief summary
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.
Detailed description
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.
Interventions
PROCEDUREPreoperative biliary drainage (ERC og PTC-aided)
Placement of biliary stent (plastic, covered SEMS, uncovered SEMS) endoscopic by ERC or placement of plastic catheter by PTC
Sponsors
Rigshospitalet, Denmark
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* All patients who had undergone pancreatoduodenectomy
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 30-day Readmission | up to 30-days from hospital discharge | Prevalence of readmission within 30-days after discharge following pancreatoduodenectomy. |
| 30-day Mortality | up to 30 days | 30-day mortality rate post-pancreatoduodenectomy |
| 90-day Mortality | up to 90 days | 90-day mortality rate post-pancreatoduodenectomy |
| Length of Hospital Stay | Days from admission until discharge, up to 390 days, median time 13 days | Accumulated length of hospital stay from the admission day prior to pancreatoduodenectomy, till the day of discharge. |
| Post-operative complication score (Clavien-Dindo) | During hospital admission, median time 13 days, up to 390 days. | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time from Bile Duct Drainage to Pancreatoduodenectomy | Days from bile duct decompression to pancreatoduodenectomy, median time 32 days, up to 534 days | Time from Bile Duct Decompression to pancreatoduodenectomy. |
| Histological Specimen | Obtained within 21 days after resection | 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). |
| Complications following preoperative bile duct drainage | up to 7 days after bile duct drainage | Prevalence of cholangitis, pancreatitis, iatrogenic perforation, post-procedural bleeding and post-procedural thrombosis |
Countries
Denmark
Outcome results
None listed