写一个SCI introduction 主体是：伴有术前梗阻性黄疸的老年胰十二指肠切除术患者的安全性分析

Introduction:

Pancreaticoduodenectomy (PD) is a complex surgical procedure that involves the removal of the head of the pancreas, duodenum, gallbladder, and common bile duct. This surgical procedure is commonly performed to treat malignant tumors, chronic pancreatitis, and other conditions affecting the pancreatic and biliary structures. However, PD is associated with a high risk of complications, including bleeding, infection, pancreatic fistula, and delayed gastric emptying. One of the most significant complications of PD is postoperative obstructive jaundice, which occurs in up to 20% of cases.

Obstructive jaundice is a condition in which there is a blockage of the bile ducts, leading to the accumulation of bilirubin in the bloodstream and subsequent yellowing of the skin and eyes. Obstructive jaundice can be caused by various factors, including the formation of a postoperative stricture or a leakage from the anastomosis. Obstructive jaundice can significantly impact the postoperative recovery of patients undergoing PD, resulting in prolonged hospital stays, increased morbidity and mortality rates, and decreased quality of life.

Older patients undergoing PD are particularly susceptible to postoperative complications, including obstructive jaundice. Aging is associated with various physiological changes, such as decreased immune function, decreased organ reserve, and increased susceptibility to infections. In addition, older patients often have comorbidities, such as cardiovascular disease, diabetes, and hypertension, which can further increase the risk of postoperative complications.

The aim of this study is to analyze the safety of PD in older patients with preoperative obstructive jaundice. We will review the medical records of patients aged 65 years and older who underwent PD with preoperative obstructive jaundice between January 2015 and December 2020. We will compare the postoperative outcomes of these patients with those who underwent PD without obstructive jaundice. The primary endpoint of this study is the incidence of postoperative complications, including pancreatic fistula, delayed gastric emptying, and wound infections. The secondary endpoints include the length of hospital stay, mortality rates, and quality of life.

In conclusion, PD is a complex surgical procedure that is associated with a high risk of complications, particularly in older patients with preoperative obstructive jaundice. This study aims to analyze the safety of PD in this patient population and provide insights into the management of postoperative complications. The results of this study may help clinicians to better assess the risks and benefits of PD in older patients with obstructive jaundice and develop strategies to minimize postoperative complications.