Does Preoperative Biliary Drainage Compromise the Long-Term Survival of Patients With Pancreatic Head Carcinoma?

Background and ObjectivesThe aim of this study was to determine the impact of preoperative biliary drainage (PBD) on long-term survival in patients with pancreatic head carcinoma after surgical resection. MethodsMedical records of 160 patients with pancreatic head carcinoma who underwent surgical resection were reviewed retrospectively. Clinicopathological parameters including long-term survival were compared between patients who did and did not undergo PBD. ResultsOverall survival of patients who underwent PBD (n=93) was significantly worse than that of patients who did not (n=67) by univariate analysis (P=0.030). However, multivariate analysis revealed that PBD was not an independent prognostic factor for overall survival (P=0.227). Patients who underwent percutaneous transhepatic biliary drainage (PTBD) had significantly worse survival than patients who underwent endoscopic retrograde biliary drainage (ERBD, P=0.038) and patients who did not undergo PBD (P=0.001). The rate of peritoneal recurrence in patients who underwent PTBD was significantly higher than that of patients who underwent ERBD (P=0.033) or patients who did not undergo PBD (P=0.034). ConclusionsPBD may not affect the long-term survival of patients with pancreatic head carcinoma if ERBD is used. J. Surg. Oncol. 2015 111:270-276. (c) 2014 Wiley Periodicals, Inc.