Related Experiment Video
Updated: Aug 30, 2026
Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy
Published on: March 17, 2026
The effect of preoperative biliary stenting on postoperative complications after pancreaticoduodenectomy
Pamela Hodul1, Steve Creech, Jack Pickleman
1Divisions of Surgical Oncology, Surgical Service Hines VA Hospital, Hines, IL, USA.
Background:
Preoperative biliary drainage (PBD) in jaundiced patients undergoing pancreaticoduodenectomy remains controversial.
Methods:
Patients presenting with obstructive jaundice who subsequently underwent pancreaticoduodenectomy from January 1996 to June 2002 were included in the study (n = 212). Patients with preoperative biliary stents (n = 154) were compared with patients without preoperative drainage (n = 58).
Results:
Patients in the stented group required a longer operative time (mean 6.8 hours versus 6.5 hours) and had greater intraoperative blood loss (mean 1207 mL versus 1122 mL) compared with the unstented group, (P = 0.046 and 0.018). No differences were found with respect to operative mortality (2%), incidence of pancreatic fistula (10% versus 14%), or intraabdominal abscess (7% versus 5%). Wound infection occurred more often in the stented group (8% versus 0%, P = 0.039).
Conclusions:
PBD was associated with increased operative time, intraoperative blood loss, and incidence of wound infection. Although PBD did not increase major postoperative morbidity and mortality, it should be used selectively in patients undergoing pancreaticoduodenectomy.
