Preoperative Stenting for Benign and Malignant Periampullary Diseases: Unnecessary if Not Harmful

Surg Clin North Am. 2018 Feb;98(1):37-47. doi: 10.1016/j.suc.2017.09.005.


Preoperative biliary drainage (PBD) is often performed in patients with jaundice with the presumption that it will decrease the risk of postoperative complications. PBD carries its own risk of complications and, therefore, has been controversial. Multiple randomized controlled trials and metaanalyses have shown that PBD has significantly increased overall complications compared with surgery alone. As such, the routine application of PBD should be avoided except in a subset of clinical situations. This is discussed in detail in this article.

Keywords: Obstructive jaundice; Periampullary cancer; Preoperative biliary drainage; Preoperative stenting.

Publication types

  • Review

MeSH terms

  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Common Bile Duct / diagnostic imaging
  • Common Bile Duct / surgery
  • Common Bile Duct Neoplasms* / complications
  • Common Bile Duct Neoplasms* / diagnosis
  • Common Bile Duct Neoplasms* / surgery
  • Drainage / methods
  • Humans
  • Jaundice, Obstructive / diagnosis
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / surgery*
  • Pancreaticoduodenectomy*
  • Preoperative Care / methods*
  • Stents*
  • Unnecessary Procedures*