Comparison of Spectrum of Complications after Pancre aticoduodenectomy in Patients with or without Preop erative Biliary Stents = Comparison of Spectrum of Complications after Pancre aticoduodenectomy in Patients with or without Preop erative Biliary Stents

다국어 초록 (Multilingual Abstract)

Aims: Preoperative biliary drainage (PBD) prior to Pancraticoduodenectomy (PD) continues to be routine in many centres despite sufficient evidence showing PBD to increase perioperative complications. This study was planned to see complications of PD and compare between stented and non-stented.
Methods: Total 59 patients were enrolled in a period of one and half year. During surgery bile aspirate was sent routinely for culture sensitivity. Drain fluid amylase and LFT were obtained on day 3, 7 and 10. Morbidity was graded according to the Clavien-Dindo classification. Pancreatic fistula, haemorrhage and DGE were documented as per international guidelins. USG Abdomen was done on POD7. Patients were assessed daily for complications as per ISGPS definition.
Results: Fifty Nine patients were enrolled. 21 were stented and 38 were not stented. Median age was 62 and 55 respectively.. DGE in 13 stented and 24 non-stented patients. Pancreatic fistula occurred in 7 (33%) stented and 8(21%) non -stented group. No significant difference was found in two groups.Fever was documented in 5 stented and 4 non-stented . Post PD haemorrhage occured in three patients and no difference between scented and non-stented. Bile culture was sterile in Two (9.5%) stented and 28 (73%) non stented patients. This was significant. Enterococci were most common isolate on stented patients accounting for 33% . E coli were most common among non-stetted .
Conclusions: We could not find significant difference in morbidity, hospital stay and operative time between the stented and non-stented groups after Pancreaticoduodenectomy. There was significant difference in bile culture positivity.