The Optimal Preoperative Bilirubinemia Level in Malignant Obstructive Jaundice Patients
The optimal preoperative level of serum bilirubin before palliative and curative interventions in 215 obstructive malignant jaundice patients was analyzed. In 75 patients endoscopic stenting, in 86 - biliodigestive bypass and in 54 - curative surgery was carried out. An analysis of correlation and frequency has shown, that the least number of complications was observed at a preoperative bilirubin level <120mmol/l before palliative interventions and <60mmol/l before curative surgery. Overall morbidity was significantly adversely affected in patients with preoperative serum bilirubin level >120mmol/l after palliative interventions compared with those <120mmol/l (15,8% vs 2,7% after endoscopic stenting and 54% vs. 13,3% after palliative bypass). After radical surgery in patients with preoperative serum bilirubin level >60mmol/l overall morbidity was significantly higher than those <60mmol/l (60% vs 32,3%). Postoperative mortality in too groups of patients came to 15% and 5,9%, respectively, but the difference was not statistically significant. Correlation analysis demonstrated that both serum bilirubin and serum protein remained significant predictors of postoperative results.