The objective of this study was to investigate the effects of different preoperative biliary drainage (PBD) methods on complications in jaundiced patients following
pancreaticoduodenectomy. We retrospectively analyzed 270 extrahepatic bile duct
cancer patients who underwent
pancreaticoduodenectomy. A total of 170 patients without PBD treatment were defined as the non-PBD group. According to different PBD methods, 45, 18, and 37 patients were classified into the percutaneous transhepatic biliary drainage (
PTBD), endoscopic nasobiliary drainage (ENBD), and endoscopic retrograde biliary
stent (ERBS) groups, respectively. Clinical characteristics and complications were compared among the 4 groups. Preoperative
cholangitis occurred in 14 (8.2%) and 8 (21.6%) patients in the non-PBD and ERBS group, respectively (Pā=ā0.04). Compared with the non-PBD group, delayed gastric emptying (DGE) and
wound infection occurred significantly more often in the ERBS group. The incidence of severe complications was significantly lower in the
PTBD group than the non-PBD group (Pā=ā0.03). Postoperative
hospital stay and complication rates were significantly higher in the ERBS group than the
PTBD group. There were no significant differences in complications between ENBD and other groups. In conclusion,
PTBD can improve surgical outcomes by reducing severe complication rate in jaundiced patients following
pancreaticoduodenectomy. ERBS increased the rates of DGE and
wound infection due to high incidence of
cholangitis before operative intervention and should be avoided. ENBD carried no special effect on complications and needs further analysis.