关键词: 梗阻性黄疸, 有创操作, 胰十二指肠切除术, 手术相关并发症

Abstract: Objective To investigate the effect of preoperative non-biliary drainage related invasive procedures on postoperative complications of pancreaticoduodenectomy, and to evaluate the benefits of preoperative non-biliary drainage related invasive procedures on patients.  Methods From January 2016 to July 2020, 163 patients with ampullary mass underwent pancreaticoduodenectomy. The patients were divided into the invasive operation group and the control group according to whether they underwent non-biliary drainage related invasive procedures before operation. Both groups underwent open or laparoscopic pancreaticoduodenectomy. The incidence of postoperative complications and its relationship with clinical factors were analyzed.  Results The incidence of postoperative complications in invasive group was 59.70% (40/67), including pancreatic leakage 52.24% (35/67), bile leakage 11.94%(8/67), intra-abdominal or gastrointestinal bleeding 17.91% (12/67), intra-abdominal infection 13.43% (9/67). The incidence of Clavien-Dindo grade Ⅰ~Ⅱ minor complications was 46.27% (31/67), and the incidence of Clavien-Dindo gradeⅢ~Ⅴ severe complications was 13.43% (9/67). The incidence of postoperative complications in the control group was 57.29% (55/96), including pancreatic leakage (52.08%, 50/96), bile leakage (12.50%, 12/96), abdominal or gastrointestinal bleeding (19.79%, 19/96), and abdominal infection (14.58%, 14/96). The incidence of Clavien-Dindo gradeⅠ~Ⅱ minor complications was 42.71% (41/96), and the incidence of Clavien-Dindo gradeⅢ~Ⅴ severe complications was 14.58% (14/96). There were no significant differences in the incidence of pancreatic leakage, bile leakage, intra-abdominal or gastrointestinal bleeding, intra-abdominal infection, minor and severe complications between the two groups.  Conclusion  Preoperative non-biliary drainage related invasive procedures have no significant effect on postoperative complications of pancreaticoduodenectomy. It is safe and feasible to perform preoperative non-biliary drainage related invasive procedures in patients with ampullary space occupying lesions.

Key words: obstructive jaundice, invasive procedures, pancreaticoduodenectomy, procedure-related complications