Premium
Preoperative biliary drainage
Author(s) -
Saxena Payal,
Kumbhari Vivek,
Zein Mohamad E.L.,
Khashab Mouen A
Publication year - 2015
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12394
Subject(s) - medicine , biliary drainage , percutaneous , obstructive jaundice , drainage , jaundice , surgery , complication , stent , biliary stent , radiology , ecology , biology
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 M edline, E mbase and C ochrane 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.