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Preoperative biliary drainage.
[cholangiocarcinoma]
The
role
of
preoperative
biliary
drainage
(
PBD
)
in
patients
with
distal
or
proximal
biliary
obstruction
secondary
to
resectable
tumors
has
been
a
matter
for
debate
.
A
review
of
the
literature
using
Medline
,
Embase
and
Cochrane
databases
was
undertaken
for
studies
evaluating
routes
of
drainage
(
endoscopic
or
percutaneous
)
and
stent
types
(
plastic
or
metal
)
in
patients
with
resectable
disease
.
Preoperative
biliary
drainage
is
indicated
for
relief
of
symptomatic
jaundice
,
cholangitis
,
patients
undergoing
neoadjuvant
therapy
or
those
patients
where
surgery
may
be
delayed
.
Endoscopic
methods
are
preferred
over
percutaneous
methods
because
of
lower
complication
rates
.
In
patients
with
proximal
biliary
obstruction
,
PBD
should
be
guided
by
imaging
studies
to
aid
in
selective
biliary
cannulation
for
unilateral
drainage
in
order
to
reduce
the
risk
of
cholangitis
in
undrained
liver
segments
.
Diseases
Validation
Diseases presenting
"biliary drainage"
symptom
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
cholangiocarcinoma
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