BACKGROUND: Jaundice due to @entity253 leads to multiple physiologic derangements and a decline in performance status that may result in unfavorable intra- and postoperative outcomes following a Whipple procedure. While preoperative biliary decompression may improve synthetic function, this strategy has been reported to increase the incidence of @entity166 following surgery. We hypothesized that @entity3638 at the time of pancreatoduodenectomy (PD) would be a risk factor for increased morbidity and mortality postoperatively. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project and the 2014 Procedure Targeted Pancreatectomy databases were queried for @entity1 with a @entity648 level obtained within 7  days of PD. Results were compared among @entity1 with @entity648 level percentiles <80th (0-2.9  mg/dL), 80-90th (3-7.3  mg/dL), and >90th (>7.3  mg/dL). Data were further evaluated between those with a @entity648 >= 10  mg/dL and those with a normal level and by utilizing @entity648 as a continuous variable. Outcomes included 30-day mortality and overall and serious morbidity as previously defined by ACS-NSQIP. Categorical variables were compared using chi-squared, @entity16043 's exact, Kruskal-Wallis, or Wilcoxon rank sum tests with a p   =   0.05 considered significant. RESULTS: The combined databases yielded 2556 @entity1 who had PD and a preoperative @entity648 level for analysis. When comparing @entity1 with @entity648 levels at the 80th (n   =   2055), 80-90th (n   =   273), and >90th percentiles (n   =   228), no difference was observed among groups with respect to overall and serious morbidity or mortality. Similarly, no difference in postoperative outcomes was observed between the 147 @entity1 who had a @entity648 >= 10  mg/dL and those with normal levels or when @entity648 increased when levels were analyzed as a continuous variable. CONCLUSION: Modest degrees of @entity3638 were not shown to affect morbidity and mortality following pancreatoduodenectomy. The indication and need for preoperative biliary decompression should be reserved, and utilized selectively, only for those with symptomatic, elevated @entity648 levels.

Does @entity3638 Contribute to Adverse XXXX Outcomes Following Pancreatoduodenectomy?

@entity1 :: ('9606', 'Species') :: ['patients'] @entity648 :: ('MESH:D001663', 'Chemical') :: ['bilirubin'] @entity166 :: ('MESH:D003141', 'Disease') :: ['infectious complications'] @entity253 :: ('MESH:D001660', 'Disease') :: ['biliary obstruction'] @entity16043 :: ('76720', 'Species') :: ['Fisher'] @entity3638 :: ('MESH:D006932', 'Disease') :: ['hyperbilirubinemia']
@entity1 :: (9606,Species) :: ['Patient']
