MU Digital Repository
Logo

Analysis Of preoperative risk factors affecting mortality and morbidityi in patients after surgery of biliary tract: A retrospective study

Mishra, Dilip and Bhat, Padbhanabh and Rodrigues, Gabriel and Rao, Anand (2006) Analysis Of preoperative risk factors affecting mortality and morbidityi in patients after surgery of biliary tract: A retrospective study. The Internet Journal of Surgery, 13 (1). pp. 1-6. ISSN 1528-8242

[img] PDF
Analysis Of Preoperative Risk Factors Affecting Mortality And Morbidity In Patients After Surgery Of Biliary Tract.pdf - Published Version
Restricted to Registered users only

Download (320kB) | Request a copy

Abstract

14 preoperative risk factors were evaluated in 78 patients retrospectively which have an effect on postoperative mortality and morbidity undergoing surgery of biliary tract. Risk factors considered were 5 clinical (age, disease, fever, history of jaundice, history of diabetes) and 9 biochemical (hematocrit, total leucocyte count, raised prothrombin time, serum creatinine, serum albumin, serum bilirubin, AST, ALT, ALP). The type of surgery performed was also taken into consideration. Type 1 involved CBD exploration and T tube drainage; Type 2 involved biliary enteric anastomosis; Type 3 involved major surgeries like Whipple's procedure. Patients undergoing Type 3 surgery involving resection of pancreas were at the highest risk of mortality (p value of <0.001). Preoperative risk factors - history of jaundice >21 days (p value <0.02), hematocrit of <30% (p value <0.0005), raised prothrombin time of >1.5 times control (p value <0.05) and a serum albumin of <3.0 g/dl (p value <0.05) contributed significantly to postoperative mortality. There was a proportionately higher mortality in patients >60 years of age and having malignant disease but it was not statistically significant. The complications seen most frequently after biliary surgery in order of frequency were wound infection (21%), pulmonary complications (18%), sepsis (11%), renal failure (7%), urinary tract infection (7%), GI hemorrhage (3%) and abdominal abscess (3%). Postoperative renal failure and sepsis were highly predictive of mortality. Mortality increased as the number of risk factors increased. Surgery after treatment of correctable risk factors decreased postoperative mortality and morbidity.

Item Type: Article
Subjects: Medicine > KMC Manipal > Surgery
Depositing User: KMC Manipal
Date Deposited: 27 May 2015 11:23
Last Modified: 27 May 2015 11:23
URI: http://eprints.manipal.edu/id/eprint/142799

Actions (login required)

View Item View Item