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Impact of internal biliary drainage after pancreaticoduodenectomy

  • Original article
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background

Bile acid has an important role in protecting immune systems related to gut-associated lymphoid tissue. This study was designed to evaluate the effects of internal biliary drainage after a pancreaticoduodenectomy (PD) on postoperative nutrition and complications in a randomized study.

Methods

The authors compared the morbidity, mortality, and postoperative nutritional status of 46 patients who had a hepaticojejunostomy (HJ) with a stented external biliary drainage (group E) or with a non-stented internal biliary drainage (group I) after a PD.

Results

Systemic infection was recognized in four patients in group E, while no patients in group I. Transthyretin at postoperative 28 days in group I was 15.6 ± 6.2, higher than that in group E. Retinol-binding protein at postoperative 28 days in group I was 2.6 ± 1.0 and also higher than that in group E.

Conclusion

HJ with no-stented internal biliary drainage was not associated with systemic infections and mortality, but showed the possibility of improving nutritional status.

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Abbreviations

PD:

Pancreaticoduodenectomy

HJ:

Hepaticojejunostomy

ERBD:

Endoscopic retrograde biliary drainage

PTBD:

Percutaneous transhepatic biliary drainage

WBC:

White blood cells

Lym:

Lymphocyte

TP:

Total protein

Alb:

Albumin

T-chol:

Total cholesterol

TG:

Triglyceride

Tf:

Transferrin

TTR:

Transthyretin

RBP:

Retinol-binding protein

GALT:

Gut-associated lymphoid tissue

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Authors and Affiliations

  1. Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Yasuhiro Fujino, Ippei Matsumoto, Makoto Shinzeki, Tetsuo Ajiki & Yoshikazu Kuroda

  2. Department of Surgery, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, 673-6558, Japan

    Yasuhiro Fujino

Authors
  1. Yasuhiro Fujino
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  2. Ippei Matsumoto
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  3. Makoto Shinzeki
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  4. Tetsuo Ajiki
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  5. Yoshikazu Kuroda
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Corresponding author

Correspondence to Yasuhiro Fujino.

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Fujino, Y., Matsumoto, I., Shinzeki, M. et al. Impact of internal biliary drainage after pancreaticoduodenectomy. J Hepatobiliary Pancreat Surg 16, 160–164 (2009). https://doi.org/10.1007/s00534-008-0025-y

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  • DOI: https://doi.org/10.1007/s00534-008-0025-y

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