术前减黄对低位胆道恶性梗阻性黄疸患者行胰十二指肠切除术的影响

Low level biliary malignant obstructive jaundice patients undergoing pancreaticoduo denectomy preoperative biliary drainage analysis of clinical value

【目的】探讨术前减黄对低位胆道恶性梗阻性黄疸患者行胰十二指肠切除术(pancreatico duodenectomy,PD)的影响。【方法】回顾74例总胆红素(TBIL)>85μmol/L行PD术的低位胆道恶性梗阻性黄疸患者的临床资料,将其分为术前减黄组及未减黄组,从围手术期情况、术后并发症及病死率的差异分析术前减黄对手术风险的影响。【结果】术前减黄40例,术前TBIL下降到(228.5±82.2)μmol/L,与减黄前的(338.1±88.4)μmol/L及未减黄组的(328.6±93.0)μmol/L相比具有统计学差异(P<0.05)。两组病死率、总并发症发生率及单个并发症的发生率之间无统计学差异。【结论】术前减黄可有效降低胆红素水平,改善肝功能,但不能改善术后并发症及病死率的发生率。

【Objective】To study the effect of preoperative biliary drainage in low level biliary malignant obstructive jaundice patients undergoing pancreaticoduodenectomy（PD）.【Methods】 74 cases of total bilirubin（TBIL） 〉 85 μmol/L with low malignant biliary obstructive jaundice were divided into preoperative biliary drainage group 40 cases and non-drainage group 34 cases randomly.The effects of preoperative biliary drainage on operation risk in the perioperative period,postoperative complications and mortality rate differences were analyzed retrospectively.【Results】In preoperative drainage group the TBIL dropped to（228.5±82.2） μmol/L,lower than that before drainage（338.88±88.4） μmol/L and non-drainage group（328.6±93.0） μmol/L.The difference was significant.【Conclusion】Bilirubin level could be reduced and the liver function could be improved by preoperative biliary drainage,but not the postoperative complications and mortality rate.