• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Effect of Pre-operative Bilirubin levels on post-operative mortality and morbidity after pancreatico-duodenectomy for pancreatic cancer. An analysis of 4850 patients from NSQIP database.

Effect of Pre-operative Bilirubin levels on post-operative mortality and morbidity after pancreatico-duodenectomy for pancreatic cancer. An analysis of 4850 patients from NSQIP database.

Piyush Aggarwal, MD, David Marx, PhD, Kiran Turaga, MD, Armour Forse. Creighton University Medical Center.

Introduction

Malignancy in the head of the pancreas can cause obstructive jaundice. There have been multiple studies in the past to evaluate the effect of high bilirubin levels on the post-operative mortality and morbidity however, the large database studies are lacking. In this study we used ACS NSQIP database to find whether high bilirubin levels in patients undergoing pancreatico-duodenectomy [PD] for pancreatic cancer have any effect on their intra-operative or 30 day post operative complications.

Method

Patients who underwent PD for pancreatic cancer were selected from NQIP database for year 2005 to 2011. Patients who were ventilator dependent, having current pneumonia or SIRS/ sepsis as well as who had undergone previous chemotherapy or radiotherapy were then excluded. They were then analysed for intra-operative and 30 day post-operative complications after standardizing them for various pre-operative variables such as sex, race, BMI, ASA classification, pre-operative creatinine, hematocrit and serum albumin levels. Primary outcome variable was 30-day mortality. Secondary outcomes included intra and post-operative transfusion, operative time, surgical site infections, sepsis, various pulmonary and cardiac complications, renal failure, return to OR, hospital stay and DVT. Analysis was done using SASS software. For the numeric variables we ran an analysis of covariance (general linear model) with both categorical and numeric explanatory variables. For the dichotomous response variables, the same model was run, but we assumed a binary response and hence a generalized linear model was conducted with the same explanatory variables.

Results
Total of 4580 patients were included in the analysis. There was no increase in 30 day mortality with increase Bilirubin levels. However, post operative morbidity with high bilirubin levels was statistically significant for increases in post-operative bleeding (2.68 vs 3.37; p<0.001), incidences of deep venous thromboses (2.23 vs 2.76, p<0.001) total operative time (p<0.05) and intra operative complications (2.74 vs 6.25; p<0.05) including unplanned intubation and myocardial infarctions. Further, no association with surgical site infections or overall length of stay was seen with increased bilirubin.

Conclusion
Higher Bilirubin levels are associated with increased post-operative complications, however with no increase in mortality. These data suggest that biliary drainage procedures should be considered for patient undergoing PD for pancreatic cancer.

View Poster

1,774

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals