Impact of preoperative endoscopic biliary drainage on the outcome of patients undergoing whipple's operation for periampullary carinomas

ABSTRACT

Fifty patients with obstructive jaundice due to periampullary carcinomas who are candidates for surgical resection were selected for this study. They were 31 males [62%] and 19 females [38%] with mean age 55.5 years, range from 32 to 70 years. After preoperative work up for assessment of the operability and fitness for operation all patients were subjected to pancreaticoduodenectomy after randomization into 2 groups. Group [A] included 25 patients subjected to the operation without preoperative endoscopic biliary drainage and group [B] included 25 patients subjected to the operation after preoperative endoscopic biliary drainage.Hospital mortality occurred in 3 patients [6%], 14 patients [28%] developed complications. The average hospital stay was 10.2 days differences between the two groups were evaluated statistically. We concluded that preoperative biliary drainage should be reserved only for patients in whom surgery with intent for cure has to be postpond and in patients with border line resectable tumours requiring downstaging protocol