Evidence map›Paper›PMID 42160230›Full record

Observational studyEuropean surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes2026

Does Treatment of Jaundice Matter before Pancreaticoduodenectomy? Results from an International Multicentre Recurrence after Whipple (RAW) Study.

Bibek Das, Henry Douglas Robb, Stergios Bobotis, Laith Omar Khalaf Alghazawi, Hutan Ashrafian, Madhava Pai, Matyas Fehervari, Somaiah Aroori, Duncan Spalding

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Bibek DasDepartment of Surgery and Cancer, Imperial College London, London, UK, bibek.das07@imperial.ac.uk.
Henry Douglas RobbDepartment of Surgery and Cancer, Imperial College London, London, UK.
Stergios BobotisDepartment of Surgery, Maidstone and Tunbridge Well NHS Trust, Kent, UK.
Laith Omar Khalaf AlghazawiDepartment of Surgery and Cancer, Imperial College London, London, UK.
Hutan AshrafianDepartment of Surgery and Cancer, Imperial College London, London, UK.
Madhava PaiDepartment of Surgery and Cancer, Imperial College London, London, UK.
Matyas FehervariDepartment of Surgery and Cancer, Imperial College London, London, UK.
Somaiah ArooriUniversity Hospitals Plymouth NHS Trust, Plymouth, UK.
Duncan SpaldingDepartment of Surgery and Cancer, Imperial College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe management of jaundice before pancreaticoduodenectomy (PD) remains controversial. We aimed to analyse the clinical outcomes of jaundiced patients in a large cohort of PD patients stratified by treatment pathway.

methodsData were collected from the Recurrence After Whipple's (RAW) study - an international, multicentre, retrospective cohort study of PD patients. Patients that underwent PD with subsequent histology confirmed pancreatic head ductal adenocarcinoma, ampullary adenocarcinoma, and distal cholangiocarcinoma were included in the RAW study. Patients were stratified into three groups by management of preoperative jaundice.

resultsPatients (n = 1,172) were classified into three groups: surgery while jaundiced (n = 109), surgery after successful preoperative biliary drainage (PBD) (n = 777), and not jaundiced (n = 286). Jaundice was an independent predictor of poor survival, whether treated (HR 1.45, CI 1.20-1.76) or untreated (HR 1.55, CI 1.16-2.09) pre-operatively. On multivariate analysis, PBD was associated with improved disease-free survival (HR 0.75, CI 0.58-0.97) but not overall survival (HR 0.93, CI 0.72-1.20) relative to the untreated jaundiced population. PBD was associated with a reduced, but statistically nonsignificant, risk of PD-related complications (OR 0.63 CI 0.39-1.02; p = 0.059).

conclusionWe observed a nonsignificant trend towards reduced perioperative complications and improved disease-free survival following PBD prior to PD.

Indexed as

JaundicePancreatic NeoplasmsPancreaticoduodenectomyAdenocarcinomaAgedBile Duct NeoplasmsDrainageFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalRetrospective StudiesCholangiocarcinomaJaundicePancreatic cancerPancreaticoduodenectomy

Identifiers

PMID42160230
PMCPMC13354277

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