1. Which patients benefit from preoperative biliary drainage in resectable pancreatic cancer?
- Author
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Blacker S, Lahiri RP, Phillips M, Pinn G, Pencavel TD, Kumar R, Riga AT, Worthington TR, Karanjia ND, and Frampton AE
- Subjects
- Aged, Bilirubin blood, Drainage, Female, Humans, Jaundice, Obstructive blood, Jaundice, Obstructive etiology, Jaundice, Obstructive mortality, Male, Middle Aged, Pancreatic Neoplasms blood, Pancreatic Neoplasms complications, Pancreatic Neoplasms mortality, Preoperative Care mortality, Retrospective Studies, Jaundice, Obstructive surgery, Pancreatic Neoplasms surgery
- Abstract
Recent studies have indicated that preoperative biliary drainage (PBD) should not be routinely performed in all patients suffering from obstructive jaundice before pancreatic surgery. The severity of jaundice that mandates PBD has yet to be defined. The evaluated paper examines the impact of PBD on intra-operative, and post-operative outcomes in patients initially presenting with severe obstructive jaundice (bilirubin ≥250 μmol/L). In this key paper evaluation, the impact of PBD versus a direct surgery (DS) approach is discussed. The arguments for and against each approach are considered with regards to drainage associated morbidity and mortality, resection rates, survival and the impact of chemotherapy and malnutrition. Concentrating on resectable head of pancreas tumors, this mini-review aims to scrutinize the authors' recommendations, alongside those of prominent papers in the field.
- Published
- 2021
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