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Aim: Preoperative biliary drainage is suggested for patients with jaundice, considering that surgical operations may increase postoperative complications in the presence of jaundice. The aim of this study was to test the effect of biliary drainage on possible serious complications, deaths, or period of hospital stay. Material and Methods: Between January 2012 and June 2016, 160 patients with operable and resectable periampullary tumors who were diagnosed with periampullary tumors underwent pancreaticoduodenectomy (Whipple's procedure) in Marmara University Pendik Training and Research Hospital, Department of General Surgery. The patients' demographics, accompanying comorbid diseases, type of biliary drainage, drainage duration, pre- and post-drainage laboratory data, emerging complications and need for re-hospitalization were recorded retrospectively from the accessible files and records. Results: It was observed that out of 158 patients with periampullary tumors, 116 that were operated with drainage had a higher occurrence of surgical site infections and anastomotic leaks, compared to the 42 patients that were operated without drainage. Similarly, when patient results were classified according to the Clavien-Dindo complication classification, the ratio was again against the patients that were operated with drainage. Drainage patients stayed in the hospital for a longer period; however, in terms of pancreatic fistula, re-hospitalization, need for intensive care and relaparotomy ratios, and especially in terms of mortality ratios, a difference between two patient groups was not observed. Conclusion: Investigating the data collected from patients that were operated without drainage, and specifically considering the bilirubin values of the patients who had complications, there was no threshold identified that contributed to a higher likeliness of complications. Consequently, even though there were no results to motivate recommending drainage, it was concluded that applying drainage does not create any difference in short-term prognosis, but drainage increases infectious complications. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the serum and bile concentrations of cefazolin and ceftriaxone at the third and sixth hours in an experimental obstructive jaundice model and to identify the rate of excretion of these antibiotics into the bile. Material and methods: Thirty-two Wistar albino rats were used in this study. The bile and serum levels of cefazolin were measured at the third hour in the A1 group and at the sixth hour in the A2 group, with cefazolin administered as 5 mg/rat; while the bile and serum levels of ceftriaxone were studied at the third hour in the B1 group and at the sixth hour in the B2 group, with ceftriaxone administered as 5 mg/rat. Results: After 3 hr of cefazolin administration, the serum concentration in the A1 group reached a mean of 1.8 μg/ml, while the bile concentration was 90% of the serum concentration, with a mean of 1.6 μg/ml; whereas in the B1 group, the third-hour serum concentration of ceftriaxone was 18.6 μg/ml, while the bile concentration was found to be as high as 330% of this level, i.e., 56 μg/ml. The serum value of cefazolin decreased to 1.4 μg/ml in the A2 group and ceftriaxone decreased to 3.7 μg/ml in the B2 group at the sixth hour. Conclusions: Although the excretory level of cefazolin and ceftriaxone into the bile reaches therapeutic doses, the duration for which these levels are above those required for bactericidal activity is short. Ceftriaxone is better concentrated in the serum and bile than cefazolin. [ABSTRACT FROM AUTHOR]