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Acute Pancreatitis After Percutaneous Biliary Drainage: An Obstacle in Liver Surgery for Proximal Biliary Cancer

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Abstract

Background

Percutaneous transhepatic biliary drainage (PTBD) has a crucial role in treatment of proximal biliary cancer (PBC). We assessed the incidence, risk factors, and impact of acute pancreatitis (AP) post-PTBD.

Methods

Forty patients with PBC scheduled for PTBD from January 2005 to December 2015 were enrolled. Exclusion criteria were missing clinical data, PTBD performed in other institutions, and palliative PTBD.

Result

The 40 patients comprised 8 (20%) with gallbladder cancer, 6 (15%) with intrahepatic cholangiocarcinoma, and 26 (65%) with perihilar cholangiocarcinoma. A median of 1 PTBD procedure was performed per patient; 16 (40%) patients underwent PTBD more than once. PTBD was left-sided in 14 (35.0%) patients, right-sided in 21 (52.5%), and bilobar in 5(12.5%). Seventeen (42.5%) patients had one or more drainage-related complications. Five (12.5%) patients developed AP. A significantly higher percentage of patients with than without AP developed sepsis (60.0 vs. 11.4%, respectively) and did not undergo the planned liver resection [2 (40.0%) vs. 0 (0.0%), respectively]. Significantly more patients with than without AP underwent left-sided PTBD [10 (28.6%) vs. 4 (80.0%), respectively].

Conclusion

PTBD is frequently complicated by AP. AP plays a key role in the development of sepsis. Nearly half of patients with AP lose the opportunity for surgical treatment.

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Authors and Affiliations

  1. Department of General and Oncological Surgery, Mauriziano Hospital “Umberto I”, Largo Turati, 62, 10128, Turin, Italy

    Nadia Russolillo, Andrea Massobrio, Serena Langella, Roberto Lo Tesoriere & Alessandro Ferrero

  2. Department of Interventional Radiology, Mauriziano Hospital “Umberto I”, Turin, Italy

    Paolo Carbonatto

Authors
  1. Nadia Russolillo
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  2. Andrea Massobrio
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  3. Serena Langella
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  4. Roberto Lo Tesoriere
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  5. Paolo Carbonatto
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  6. Alessandro Ferrero
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Corresponding author

Correspondence to Nadia Russolillo.

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Russolillo, N., Massobrio, A., Langella, S. et al. Acute Pancreatitis After Percutaneous Biliary Drainage: An Obstacle in Liver Surgery for Proximal Biliary Cancer. World J Surg 41, 1595–1600 (2017). https://doi.org/10.1007/s00268-017-3885-y

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  • DOI: https://doi.org/10.1007/s00268-017-3885-y

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