OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE
ABSTRACT 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. M...
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2025-07-01
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| Series: | Arquivos de Gastroenterologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032025000100901&lng=en&tlng=en |
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| author | 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 |
| author_facet | 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 |
| author_sort | Rómulo VARGAS-RUBIO |
| collection | DOAJ |
| description | ABSTRACT 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. |
| format | Article |
| id | doaj-art-9fc93b177b6e46b5aab55d9c2443aeb3 |
| institution | Matheson Library |
| issn | 1678-4219 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj-art-9fc93b177b6e46b5aab55d9c2443aeb32025-07-22T07:41:34ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192025-07-016210.1590/s0004-2803.24612024-089OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGERómulo VARGAS-RUBIOhttps://orcid.org/0000-0001-5660-6229Ana Maria LEGUIZAMO-NARANJOhttps://orcid.org/0000-0002-4523-7947Oscar MUÑOZ-VELANDIAhttps://orcid.org/0000-0001-5401-0018Cristiam David PULGARIN-HERRERAhttps://orcid.org/0000-0001-7590-458XCarlos Ernesto LOMBOhttps://orcid.org/0000-0002-6392-7554Liliana CUEVAS-LOPEZhttps://orcid.org/0000-0001-5092-3864Elio Fabio SANCHEZhttps://orcid.org/0000-0002-3503-8493Francisco Javier HENAOhttps://orcid.org/0000-0003-0679-4502ABSTRACT 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032025000100901&lng=en&tlng=enDrainageadverse effectschoangiopancreatographyendoscopic retrogradepancreaticoduodenectomyjaundiceobstructiveetiologypancreatic neoplasmscommon bile duct neoplasmspreoperative care |
| spellingShingle | 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 OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE Arquivos de Gastroenterologia Drainage adverse effects choangiopancreatography endoscopic retrograde pancreaticoduodenectomy jaundice obstructive etiology pancreatic neoplasms common bile duct neoplasms preoperative care |
| title | OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE |
| title_full | OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE |
| title_fullStr | OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE |
| title_full_unstemmed | OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE |
| title_short | OUTCOMES OF PATIENTS UNDERGOING PANCREATODUODENECTOMY (WHIPPLE’S PROCEDURE) ACCORDING TO THE PRESENCE OF PREOPERATIVE BILIARY DRAINAGE |
| title_sort | outcomes of patients undergoing pancreatoduodenectomy whipple s procedure according to the presence of preoperative biliary drainage |
| topic | Drainage adverse effects choangiopancreatography endoscopic retrograde pancreaticoduodenectomy jaundice obstructive etiology pancreatic neoplasms common bile duct neoplasms preoperative care |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032025000100901&lng=en&tlng=en |
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