Duration of Preoperative Biliary Drainage as a Prognostic Factor After Pancreaticoduodenectomy for Pancreatic Head Cancer

• Published in: Anticancer research 2017-06, Vol.37 (6), p.3215-3219
• Main Authors: Matsumoto, Michinori, Nakabayashi, Yukio, Fujiwara, Yuki, Funamizu, Naotake, Noaki, Rota, Eto, Seiichiro, Sugano, Hiroshi, Otsuka, Masahiko, Yanaga, Katsuhiko
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biliary Tract Surgical Procedures - adverse effects; Biliary Tract Surgical Procedures - methods; Biliary Tract Surgical Procedures - mortality; Chi-Square Distribution; Drainage - adverse effects; Drainage - methods; Drainage - mortality; Female; Humans; Jaundice, Obstructive - diagnosis; Jaundice, Obstructive - etiology; Jaundice, Obstructive - mortality; Jaundice, Obstructive - surgery; Kaplan-Meier Estimate; Lymphatic Metastasis; Male; Middle Aged; Multivariate Analysis; Neoadjuvant Therapy; Neoplasm Staging; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - adverse effects; Pancreaticoduodenectomy - mortality; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 0250-7005; 1791-7530
• DOI: 10.21873/anticanres.11683

Preoperative biliary drainage (PBD) is often performed for jaundiced patients. However, the optimal duration of PBD remains unknown. The aim of this study was to investigate whether duration of PBD influenced the prognosis of patients after pancreaticoduodenectomy (PD) for pancreatic head cancer. Twenty-five patients who underwent PD for pancreatic head cancer with obstructive jaundice between 2007 and 2013 were included. Tumor and host factors were analyzed to evaluate their potential prognostic effects and patients' characteristics between the two groups according to the duration of PBD were analyzed. In multivariate analysis, overall survival, duration of PBD ≥21 days and tumor-node-metastasis (TNM) stage III or IV were significant predictors. Duration of PBD ≥21 days was positively correlated with higher level of serum C-reactive protein (CRP), modified Glasgow prognostic score (mGPS) and neoadjuvant therapy. Duration of PBD is an independent prognostic factor after PD for pancreatic head cancer with obstructive jaundice.