The optimal duration of preoperative biliary drainage for periampullary tumors that cause severe obstructive jaundice

BACKGROUND: Despite routine preoperative biliary drainage (PBD) with periampullary cancer, its optimal duration has not been established. The objective of this study was to investigate PBD in severely jaundiced patients. METHODS: A total of 120 patients with periampullary tumors who underwent surgery with intent to cure after PBD for severe obstructive jaundice were enrolled. According to the duration of PBD, 66 and 54 patients were classified into the long-term (>= 2 weeks) and short-term (<2 weeks) groups. RESULTS: PBD-related complications occurred in 6 (9.1%) and 14 (25.9%) patients in the short-term and long-term groups, respectively (P = .014). Rates of surgery-related complications and mortalities were not significantly different between the 2 groups. The R0 resection rate tended to be lower (P = .054) and the mean length of hospital stay was significantly longer (P = .039) in the long-term group. CONCLUSIONS: PBD duration <2 weeks is more appropriate in severely jaundiced patients with periampullary cancer. (C) 2013 Elsevier Inc. All rights reserved.