ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2009
A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04289831 ("Impact of Preoperative Biliary Drainage on Surgical and Oncologic Outcomes After Pancreatico-Duodenectomy in Patients With Operable Malignant Periampulary Tumors. A Randomized Controlled Study"), which is not on this map. Cited by 46 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
"Impact of Preoperative Biliary Drainage on Surgical and Oncologic Outcomes After Pancreatico-Duodenectomy in Patients With Operable Malignant Periampulary Tumors. A Randomized Controlled Study"
Who cites it
46 citing papers in PubMed, 6 syntheses or guidelines pooled it, 117 citations in OpenAlex.
- The effect of preoperative biliary stents on outcomes after pancreaticoduodenectomy: A meta-analysis.Medicine · 2020Pooled it
- Prognostic Impact of Bacterobilia on Morbidity and Postoperative Management After Pancreatoduodenectomy: A Systematic Review and Meta-analysis.World journal of surgery · 2018Pooled it
- PRE-OPERATIVE BILIARY DRAINAGE IN THE PERIAMPULLARY NEOPLASIA - A SYSTEMATIC REVIEW.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2018Pooled it
- Pooled it
- Effect of Preoperative Biliary Drainage on Complications Following Pancreatoduodenectomy: A Meta-Analysis.Medicine · 2015Pooled it
- A meta-analysis of the effect of preoperative biliary stenting on patients with obstructive jaundice.Medicine · 2014Pooled it
- Impact of preoperative biliary drainage on surgical risk in pancreaticoduodenectomy for resectable periampullary tumors.Translational gastroenterology and hepatology · 2026Article
- Self-expandable metal vs. plastic stents for preoperative biliary drainage in patients receiving neoadjuvant chemotherapy.Clinical endoscopy · 2025Review
- Biliary Drainage for the Preoperative Management of Periampullary Neoplasms: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2025Article
- Article
- The role of preoperative biliary drainage on postoperative outcome after pancreaticoduodenectomy in patients with obstructive jaundice.Gland surgery · 2023Article
- Article
- Clinical Impact of Preoperative Biliary Drainage in Patients with Ductal Adenocarcinoma of the Pancreatic Head.Diagnostics (Basel, Switzerland) · 2023Article
- Impact of Neoadjuvant Chemotherapy and Pretreatment Biliary Drainage for Pancreatic Head Ductal Adenocarcinoma.Digestive diseases and sciences · 2022Article
- Perioperative outcome of Whipple's procedure with special attention to the impact of preoperative biliary drainage: a real-life scenario.Updates in surgery · 2021Article
- 147 Pancreatoduodenectomies: a Single Center's Perspective into the Epidemiology and Surgical Outcomes of Periampullary and Pancreatic Cancers in South India.Journal of gastrointestinal cancer · 2021Observational
- Surgical management of biliary malignancy.Current problems in surgery · 2021Article
- Outcomes with Preoperative Biliary Stenting After Pancreaticoduodenectomy In the Modern Era.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- The pivotal predictor of severe postoperative complications of pancreatoduodenectomy: complex links of bacterial contamination from preoperative biliary drainage.Surgery today · 2020Article
- Does the Microbiology of Bactibilia Drive Postoperative Complications After Pancreatoduodenectomy?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreoperative biliary drainage (PBD) prior to pancreaticoduodenectomy (PD) continues to be routine in many centers despite retrospective and randomized data showing that PBD increases perioperative infectious complications.
methodsReview of a prospectively maintained database identified 340 consecutive patients with pancreatic adenocarcinoma who underwent PD between 2000 and 2005. From this cohort, 94 PBD and 94 nonstented (no-PBD) patients were matched for age, gender, preoperative albumin, and bilirubin levels (PBD group: prestent bilirubin; no-PBD group: preoperative bilirubin).
resultsThe majority of PBD patients (89%) underwent internal endoscopic biliary drainage. Stent-related complications occurred in 46 patients (23%) and resulted in a significant delay in time to resection. In the matched-pair comparison, there was more operative blood loss in PBD patients, but similar operative times, transfusions, and hospital stay. Bile cultures were positive in 82% of PBD patients versus 7% no PBD. There was a statistically significant increase in infectious complications including wound infections and intra-abdominal abscess in PBD patients, but equal incidence of anastomotic leak.
conclusionsIn this case-matched control study, PBD was associated with a stent-related complication rate of 23% and resulted in a twofold increase in postpancreatectomy infectious complications. The routine use of PBD remains unjustified.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.