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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preoperative biliary drainage | Patients who had undergone preoperative biliary drainage (ERC og PTC) prior to pancreatoduodenectomy |
| |
| No preoperative biliary drainage | Patients who had not undergone preoperative biliary drainage (ERC og PTC) prior to pancreatoduodenectomy |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative biliary drainage (ERC og PTC-aided) | Procedure | Placement of biliary stent (plastic, covered SEMS, uncovered SEMS) endoscopic by ERC or placement of plastic catheter by PTC |
| Measure | Description | Time Frame |
|---|---|---|
| Post-operative complication score (Clavien-Dindo) | 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. | During hospital admission, median time 13 days, up to 390 days. |
| 30-day Mortality | 30-day mortality rate post-pancreatoduodenectomy | up to 30 days |
| 90-day Mortality | 90-day mortality rate post-pancreatoduodenectomy | up to 90 days |
| Length of Hospital Stay | Accumulated length of hospital stay from the admission day prior to pancreatoduodenectomy, till the day of discharge. | Days from admission until discharge, up to 390 days, median time 13 days |
| 30-day Readmission | Prevalence of readmission within 30-days after discharge following pancreatoduodenectomy. | up to 30-days from hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Complications following preoperative bile duct drainage | Prevalence of cholangitis, pancreatitis, iatrogenic perforation, post-procedural bleeding and post-procedural thrombosis | up to 7 days after bile duct drainage |
| Time from Bile Duct Drainage to Pancreatoduodenectomy |
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Inclusion Criteria:
Exclusion Criteria:
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All patients who had undergone pancreatoduodenectomy from January 1st, 2015 to September 31, 2021
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rigshospitalet | Copenhagen | Capitol | 2100 | Denmark |
The datasets generated and/or analyzed during the current study are not publicly available due to a restriction agreement with the Danish Data Protection Agency but are available from the corresponding author on reasonable request.
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| D001658 | Biliary Fistula |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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Time from Bile Duct Decompression to pancreatoduodenectomy. |
| Days from bile duct decompression to pancreatoduodenectomy, median time 32 days, up to 534 days |
| Histological Specimen | 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). | Obtained within 21 days after resection |
| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D016154 | Digestive System Fistula |
| D005402 | Fistula |
| D020763 | Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |