Whether T-tube biliary drainage is necessary after pancreaticoduodenectomy: a single-center retrospective study

BMC Surg. 2024 Sep 20;24(1):269. doi: 10.1186/s12893-024-02570-5.

Abstract

Background: Postoperative complications of pancreaticoduodenectomy (PD) are still a thorny problem. This study aims to verify the preventative impact of T-tube on them.

Methods: The electronic medical records and follow-up data of patients who received pancreaticoduodenectomy in our center from July 2016 to June 2020 were reviewed. According to whether T tube was placed during the operation, the patients were divided into T-tube group and not-T-tube group. Propensity score matching analysis was performed to minimize selection bias.

Results: A total of 330 patients underwent PD (Not-T-tube group =226, T-tube group=104). Propensity score matching resulted in 222 patients for further analysis (Not-T-tube group =134, T-tube group=88). Patients' demographics were comparable in the matched cohorts. Significantly higher incidences of clinically relevant postoperative pancreatic fistula (CR-POPF) ((14 (10.45%) VS 20 (22.73%)), P=0.013) were observed in the T-tube group. The total incidence of biliary anastomotic stricture (BAS) was 3.15%. The incidence was slightly lower in the T-tube group, but there was no statistically significant differentiation (6 (4.48%) VS 1 (1.14%), P=0.317).

Conclusions: It is not feasible to prevent postoperative complications with the application of a T-tube in PD.

Keywords: Biliary anastomotic stricture; Pancreaticoduodenectomy; T-tube.

MeSH terms

  • Adult
  • Aged
  • Drainage* / instrumentation
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pancreatic Fistula* / epidemiology
  • Pancreatic Fistula* / etiology
  • Pancreatic Fistula* / prevention & control
  • Pancreaticoduodenectomy* / adverse effects
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Postoperative Complications* / prevention & control
  • Propensity Score*
  • Retrospective Studies