Korean J Hepatobiliary Pancreat Surg.  2011 Nov;15(4):231-236. 10.14701/kjhbps.2011.15.4.231.

Effectiveness of external drainage of the bile duct in pancreaticoduodenectomy: a single surgeon's experience

• Yoon JH
• Kim KH
• Namgoong J
• Yoon SY
• Jung SW
• Park YH
• Park HW
• Park CS
• Lee HJ
• Park DH
• Lee SS
• Seo DW
• Lee SK
• Kim MH
• Hwang S
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Lee SG

• KMID: 2244130
• DOI: http://doi.org/10.14701/kjhbps.2011.15.4.231

Abstract

BACKGROUNDS/AIMS
The rates of surgery-related complications during and after pancreaticoduodenectomy (PD) remain very high, reaching up to 41%. They were primarily caused by leakage of pancreatic juice. We evaluated the effectiveness of external drainage of the bile duct using a pigtail drain to prevent pancreatic leakage in patients undergoing PD.
METHODS
We evaluated 79 patients who underwent PD using a single-layer continuous suture between the pancreatic parenchyma and jejunum after duct-to-mucosa anastomosis by a single surgeon from April 2005 to December 2008. Of the 79, 44 underwent external drainage (ED) of the bile duct using a pigtail drain, performed in the intraoperative field via a retrograde transhepatic approach, whereas 35 did not undergo ED.
RESULTS
Age, sex distribution, number of total complications, pancreatic duct size, pancreatic texture and duration of hospital stay did not differ between patients who did and did not undergo ED. In groups with or without ED, 0 and 4 patients, respectively, showed leakage of pancreatic juice and the difference was statistically significant (p=0.02).
CONCLUSIONS
The fact that none of the patients who underwent external drainage experienced pancreatic leakage, suggests that external drainage of the bile duct with a pigtail drain to decompress the jejunum and to drain pancreatic and bile juice is useful in preventing the complications of pancreatic leakage.

Keyword

Pancreaticoduodenectomy; Pancreaticojejunostomy; Leakage

MeSH Terms

Bile
Bile Ducts
Drainage
Humans
Jejunum
Length of Stay
Pancreatic Ducts
Pancreatic Juice
Pancreaticoduodenectomy
Pancreaticojejunostomy
Sex Distribution
Sutures

Figure

• 

  Fig. 1 External drainage of the bile duct with a pigtail drain.

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