Preoperative biliary drainage

Payal Saxena, Vivek Kumbhari, Mohamad E.L. Zein, Mouen A. Khashab

Research output: Contribution to journalReview articlepeer-review

Abstract

The role of preoperative biliary drainage (PBD) in patients with distal or proximal biliary obstruction secondary to resectable tumors has been a matter for debate. A review of the literature using Medline, Embase and Cochrane databases was undertaken for studies evaluating routes of drainage (endoscopic or percutaneous) and stent types (plastic or metal) in patients with resectable disease. Preoperative biliary drainage is indicated for relief of symptomatic jaundice, cholangitis, patients undergoing neoadjuvant therapy or those patients where surgery may be delayed. Endoscopic methods are preferred over percutaneous methods because of lower complication rates. In patients with proximal biliary obstruction, PBD should be guided by imaging studies to aid in selective biliary cannulation for unilateral drainage in order to reduce the risk of cholangitis in undrained liver segments.

Original languageEnglish (US)
Pages (from-to)265-277
Number of pages13
JournalDigestive Endoscopy
Volume27
Issue number2
DOIs
StatePublished - Jan 1 2015

Keywords

  • borderline resectable pancreatic cancer
  • cholangiocarcinoma
  • neoadjuvant therapy
  • pancreatic cancer
  • preoperative biliary drainage

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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