Objective:To evaluate the effect of preoperative biliary drainage (PBD) on postoperative complications and long-term survival of patients with periampullary cancer.Methods:Clinical data of 114 patients with periampullary cancer who underwent pancreaticoduodenectomy in the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to June 2018 were retrospectively analyzed. Among them, 75 patients were male and 39 female, aged from 39 to 78 years, with a median age of 62 years. 55 patients were diagnosed with ampullary carcinoma, 52 cases of distal cholangiocarcinoma and 7 cases of carcinoma of the duodenal papilla. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients were divided into the PBD (n=36) and non-drainage groups (n=78) according to whether preoperative PBD was performed. Perioperative and postoperative complications and long-term survival were compared between two groups. Perioperative parameters betweentwo groups were compared by t test or Mann-Whitney U test. The incidence of complications was compared byChi-square test. Survival analysis was performed by Kaplan-Meier method and Log-rank test.Results:In the PBD group, the median postoperative TB level was 110(132) μmol/L, significantly lower than 156(117) μmol/L in the non-drainage group (Z=-2.588, P<0.05). The change value of postoperative TB level in the PBD group was 43(163) μmol/L, significantly higher than 25(87) μmol/L in the non-drainage group (Z=2.140, P<0.05). In the PBD group, the total incidence of postoperative complications was 72%(56/78), and 67%(24/36) in the non-drainage group, where no significant difference was observed (χ2=0.310, P>0.05). Survival analysis showed that the median overall survival was 24 months in the PBD group and 20 months in non-drainage group, where no significant difference was observed between two groups (χ2=0.551, P>0.05).Conclusions:For patients with periampullary cancer, preoperative PBD can significantly mitigate jaundice, whereas it brings no significant benefits for postoperative complications and long-term survival. Hence, PBD is not routinely recommended for patients with periampullary cancer complicated with obstructive jaundice.
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