Rómulo Vargas-Rubio, Ana Maria Leguizamo-Naranjo, Oscar Muñoz-Velandia, Cristiam David Pulgarin-Herrera, Carlos Ernesto Lombo, Liliana Cuevas-Lopez, Elio Fabio Sanchez, Francisco Javier Henao
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Comorbidities, functional status and procedural characteristics were recorded. The outcomes, including mortality and intraoperative and 30-day postoperative complications, were compared between groups.</p><p><strong>Results: </strong>A total of 98 patients were included, 49 of whom underwent preoperative biliary drainage. In this group, there was a higher proportion of patients with pathological stage II and III disease (77.5 vs 49.0, P=0.04) and higher preoperative bilirubin levels (median 6.4 vs 4.9 mg/dL; P=0.02). There were no differences in intraoperative (10.2% vs 14.3%; P=0.34) or postoperative (61.2% vs 51%; P=0.15) complications, but 30-day mortality was higher in patients with biliary drainage (8.2 vs 20.4%; P=0.03).</p><p><strong>Conclusion: </strong>Our data suggest that there are no differences in postoperative complications. The higher mortality rate in patients with preoperative biliary drainage may be related to differences in baseline patient characteristics and/or delays between biliary drainage and Whipple procedure.</p><p><strong>Background: </strong>• The usefulness of preoperative biliary drainage in patients undergoing Whipple procedure is still controversial.</p><p><strong>Background: </strong>• Our data suggest that there are no differences in postoperative complications.</p><p><strong>Background: </strong>• 30-day mortality is higher in patients with biliary drainage maybe related to differences in baseline characteristics and/or delays between biliary drainage and Whipple procedure.</p>","PeriodicalId":35671,"journal":{"name":"Arquivos de Gastroenterologia","volume":"62 ","pages":"e24089"},"PeriodicalIF":0.0000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289290/pdf/","citationCount":"0","resultStr":"{\"title\":\"OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE'S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE.\",\"authors\":\"Rómulo Vargas-Rubio, Ana Maria Leguizamo-Naranjo, Oscar Muñoz-Velandia, Cristiam David Pulgarin-Herrera, Carlos Ernesto Lombo, Liliana Cuevas-Lopez, Elio Fabio Sanchez, Francisco Javier Henao\",\"doi\":\"10.1590/S0004-2803.24612024-089\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pancreaticoduodenectomy is the procedure of choice for the treatment of resectable pancreaticoduodenal tumours. It has been proposed that jaundice is associated with worse outcomes, but the usefulness of preoperative biliary drainage in these patients is still controversial.</p><p><strong>Methods: </strong>Retrospective cohort study of patients undergoing Whipple procedure at the Hospital Universitario San Ignacio, Bogotá (Colombia), between January 2010 and June 2023. The cohort of patients who underwent preoperative biliary drainage was compared with those who went directly operated on. Comorbidities, functional status and procedural characteristics were recorded. The outcomes, including mortality and intraoperative and 30-day postoperative complications, were compared between groups.</p><p><strong>Results: </strong>A total of 98 patients were included, 49 of whom underwent preoperative biliary drainage. In this group, there was a higher proportion of patients with pathological stage II and III disease (77.5 vs 49.0, P=0.04) and higher preoperative bilirubin levels (median 6.4 vs 4.9 mg/dL; P=0.02). There were no differences in intraoperative (10.2% vs 14.3%; P=0.34) or postoperative (61.2% vs 51%; P=0.15) complications, but 30-day mortality was higher in patients with biliary drainage (8.2 vs 20.4%; P=0.03).</p><p><strong>Conclusion: </strong>Our data suggest that there are no differences in postoperative complications. 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引用次数: 0
摘要
背景：胰十二指肠切除术是治疗可切除胰十二指肠肿瘤的首选手术方法。已经提出黄疸与较差的预后相关，但术前胆道引流对这些患者的有用性仍然存在争议。方法：对2010年1月至2023年6月在波哥大圣伊格纳西奥大学医院接受惠普尔手术的患者进行回顾性队列研究。将术前行胆道引流的患者与直接行手术的患者进行比较。记录合并症、功能状态和手术特点。比较两组之间的结果，包括死亡率、术中及术后30天并发症。结果：共纳入98例患者，其中49例术前行胆道引流。在该组中，出现病理性II期和III期疾病的患者比例较高（77.5 vs 49.0， P=0.04），术前胆红素水平较高(中位值6.4 vs 4.9 mg/dL；P = 0.02)。术中两组差异无统计学意义(10.2% vs 14.3%；P=0.34)或术后(61.2% vs 51%；P=0.15)并发症，但胆道引流患者的30天死亡率更高(8.2 vs 20.4%；P = 0.03)。结论：我们的数据显示两组术后并发症无差异。术前胆道引流患者较高的死亡率可能与基线患者特征的差异和/或胆道引流与惠普尔手术之间的延迟有关。背景：•术前胆道引流在Whipple手术患者中的有效性仍存在争议。背景：•我们的数据表明，术后并发症没有差异。背景：•胆道引流患者的30天死亡率较高，可能与胆道引流和惠普尔手术的基线特征和/或延迟有关。
OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE'S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE.
Background: Pancreaticoduodenectomy is the procedure of choice for the treatment of resectable pancreaticoduodenal tumours. It has been proposed that jaundice is associated with worse outcomes, but the usefulness of preoperative biliary drainage in these patients is still controversial.
Methods: Retrospective cohort study of patients undergoing Whipple procedure at the Hospital Universitario San Ignacio, Bogotá (Colombia), between January 2010 and June 2023. The cohort of patients who underwent preoperative biliary drainage was compared with those who went directly operated on. Comorbidities, functional status and procedural characteristics were recorded. The outcomes, including mortality and intraoperative and 30-day postoperative complications, were compared between groups.
Results: A total of 98 patients were included, 49 of whom underwent preoperative biliary drainage. In this group, there was a higher proportion of patients with pathological stage II and III disease (77.5 vs 49.0, P=0.04) and higher preoperative bilirubin levels (median 6.4 vs 4.9 mg/dL; P=0.02). There were no differences in intraoperative (10.2% vs 14.3%; P=0.34) or postoperative (61.2% vs 51%; P=0.15) complications, but 30-day mortality was higher in patients with biliary drainage (8.2 vs 20.4%; P=0.03).
Conclusion: Our data suggest that there are no differences in postoperative complications. The higher mortality rate in patients with preoperative biliary drainage may be related to differences in baseline patient characteristics and/or delays between biliary drainage and Whipple procedure.
Background: • The usefulness of preoperative biliary drainage in patients undergoing Whipple procedure is still controversial.
Background: • Our data suggest that there are no differences in postoperative complications.
Background: • 30-day mortality is higher in patients with biliary drainage maybe related to differences in baseline characteristics and/or delays between biliary drainage and Whipple procedure.
期刊介绍：
The journal Arquivos de Gastroenterologia (Archives of Gastroenterology), a quarterly journal, is the Official Publication of the Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia IBEPEGE (Brazilian Institute for Studies and Research in Gastroenterology), Colégio Brasileiro de Cirurgia Digestiva - CBCD (Brazilian College of Digestive Surgery) and of the Sociedade Brasileira de Motilidade Digestiva - SBMD (Brazilian Digestive Motility Society). It is dedicated to the publishing of scientific papers by national and foreign researchers who are in agreement with the aim of the journal as well as with its editorial policies.
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