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已发表论文
一项回顾性研究以确定胰十二指肠切除术术前胆道引流以降低并发症发生率的术前胆红素水平
Authors Chu X, Tong K, Liu K, Wu H, Li H, Liu J, Li Z, Zhang M, Guo W
Received 11 June 2025
Accepted for publication 31 October 2025
Published 7 November 2025 Volume 2025:18 Pages 6769—6781
DOI https://doi.org/10.2147/IJGM.S546424
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Xudong Zhu
Xiangyu Chu,* Kuinan Tong,* Kun Liu, Hongwei Wu, Haonan Li, Jie Liu, Zhonghao Li, Mingcheng Zhang, Wei Guo
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Diseases, Beijing, 100050, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wei Guo, Email guowei@ccmu.edu.cn
Background: Preoperative biliary drainage is used to alleviate obstructive jaundice before pancreaticoduodenectomy in jaundiced patients, but its effect on reducing the short-term postoperative complications is still controversial.
Methods: Data were collected retrospectively from patients (n = 292) with benign and malignant diseases around the ampulla who underwent pancreaticoduodenectomy in this study. Intergroup comparisons were performed using statistical methods such as t-tests and chi-square tests. The optimal preoperative total bilirubin was identified through receiver operating characteristic curve analysis.
Results: A total of 292 patients (jaundiced patients:141, non-jaundice:151) were collected in this study. Compared with non-jaundice patients, the incidence of postoperative bleeding events (P = 0.004), short-term complications (P = 0.038), and severe short-term complications (P = 0.025) was significantly increased in jaundiced patients. The incidence of short-term postoperative complications in patients with severe jaundice was not statistically different from that in patients with mild jaundice after preoperative biliary drainage. In patients with mild jaundice, there was no statistically significant difference between the direct surgery group and the preoperative biliary drainage group. When the preoperative total bilirubin in preoperative biliary drainage patients decreased to 151.8μmol/L, the incidence of severe short-term postoperative complications was significantly reduced (P = 0.047).
Conclusion: Preoperative biliary drainage can effectively improve liver function and decrease the short-term complications after pancreaticoduodenectomy for severe jaundiced patients. Routine preoperative biliary drainage is not recommended in patients with mild jaundice. It is recommended to reduce the total bilirubin to less than 151.8μmol/L, which can effectively decrease the severe short-term postoperative complications.
Keywords: pancreaticoduodenectomy, jaundice, preoperative biliary drainage, postoperative complications, target total bilirubin
Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, State Key Laboratory of Digestive Health, National Clinical Research Center for Digestive Diseases, Beijing, 100050, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Wei Guo, Email guowei@ccmu.edu.cn
Background: Preoperative biliary drainage is used to alleviate obstructive jaundice before pancreaticoduodenectomy in jaundiced patients, but its effect on reducing the short-term postoperative complications is still controversial.
Methods: Data were collected retrospectively from patients (n = 292) with benign and malignant diseases around the ampulla who underwent pancreaticoduodenectomy in this study. Intergroup comparisons were performed using statistical methods such as t-tests and chi-square tests. The optimal preoperative total bilirubin was identified through receiver operating characteristic curve analysis.
Results: A total of 292 patients (jaundiced patients:141, non-jaundice:151) were collected in this study. Compared with non-jaundice patients, the incidence of postoperative bleeding events (P = 0.004), short-term complications (P = 0.038), and severe short-term complications (P = 0.025) was significantly increased in jaundiced patients. The incidence of short-term postoperative complications in patients with severe jaundice was not statistically different from that in patients with mild jaundice after preoperative biliary drainage. In patients with mild jaundice, there was no statistically significant difference between the direct surgery group and the preoperative biliary drainage group. When the preoperative total bilirubin in preoperative biliary drainage patients decreased to 151.8μmol/L, the incidence of severe short-term postoperative complications was significantly reduced (P = 0.047).
Conclusion: Preoperative biliary drainage can effectively improve liver function and decrease the short-term complications after pancreaticoduodenectomy for severe jaundiced patients. Routine preoperative biliary drainage is not recommended in patients with mild jaundice. It is recommended to reduce the total bilirubin to less than 151.8μmol/L, which can effectively decrease the severe short-term postoperative complications.
Keywords: pancreaticoduodenectomy, jaundice, preoperative biliary drainage, postoperative complications, target total bilirubin