Preoperative biliary decompression in patients, suffering tumorogenic obturation jaundice, complicated by cholangitis, and its impact on development of postoperative complications

Keywords: obturation jaundice, preoperative biliary decompression, ascending cholangitis, postoperative complications, hyperbilirubinemia, antibioticoresistence

Abstract

Objective.To estimate the impact of preoperative biliary decompression inpatients, suffering tumorogenic obturation jaundice, complicated by ascending cholangitis, on development of postoperative complications.

Materials and methods. The one-centre retrospective investigation of the treatment results was conducted in 136 patients, suffering tumorogenic obturation jaundice. In 84 patients preoperative biliary decompression was done (Group I). In 52 patients preoperative biliary decompression was not performed (Group II).In all the Group I patients an ascending preoperative cholangitis was diagnosed: in 48 (57.1%) -of the I degree severity, in 36 (42.9%) - of the II degree of severity. In 21 (40.4%) patients of Group II preoperative ascending cholangitis I degree of severity was revealed.

Results. Performance of preoperative biliary decompression did not worsen postoperative results, taking into account the postoperative complications structure (p=0.07), but influenced the wound infection development (p=0.01). Additional factors were determined: preoperative ascending cholangitis of I degree (p=0.007) and II degree (p=0.001) of severity; hyperbilirubinemia over 250 mcmol/l (p= 0.03); delay in operative treatment more than by 3 weeks after preoperative biliary decompression (р= 0.02); presence of the antibioticoresistant microflora in a time of preoperative biliary decompression (p=0.009) and at the operation time (p=0.002).

Conclusion. Performance of preoperative biliary decompression raises the risk for the wound infection development, but is not the cause for postoperative prognosis worsening, taking into account the postoperative complications structure.

Author Biographies

O. І. Dronov, Bogomolets National Medical University, Kyiv

Dronov Olexiy I., MD, DSci(Med), Professor,
Head of Department of General Surgery No. 1
Bogomolets National Medical University, Kyiv, Ukraine
+380672092121
ai_dronov@ukr.net
https://orcid.org/0000-0003-4033-3195

L. V. Levchenko, Bogomolets National Medical University, Kyiv

Levchenko Liudmyla V., Postgraduate Student
Assistant of Department of General Surgery No. 1
Bogomolets National Medical University, Kyiv, Ukraine
+380980758548
lev4enkolv@gmail.com
https://orcid.org/0000-0003-1356-6647

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Published
2021-11-28
How to Cite
DronovO. І., & Levchenko, L. V. (2021). Preoperative biliary decompression in patients, suffering tumorogenic obturation jaundice, complicated by cholangitis, and its impact on development of postoperative complications. Klinicheskaia Khirurgiia, 88(9-10), 3-10. https://doi.org/10.26779/2522-1396.2021.9-10.03
Section
General Problems of Surgery