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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Jaundice01:25

Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...

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Related Experiment Video

Updated: May 18, 2026

Intraoperative Strategy under Complex Vascular Adhesion for Laparoscopic Radical Resection of Bismuth-Corlette Type IIIb Perihilar Cholangiocarcinoma
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Pre-operative biliary drainage for obstructive jaundice.

Yuan Fang1, Kurinchi Selvan Gurusamy, Qin Wang

  • 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

The Cochrane Database of Systematic Reviews
|September 14, 2012
PubMed
Summary
This summary is machine-generated.

Pre-operative biliary drainage for obstructive jaundice does not significantly impact mortality but may increase serious adverse events. Routine use is not recommended due to insufficient evidence and potential harm.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Hepatology

Background:

  • Obstructive jaundice causes systemic pathophysiological changes affecting multiple organs.
  • The benefit of pre-operative biliary drainage (PBD) before major surgery for obstructive jaundice remains controversial.

Purpose of the Study:

  • To evaluate the benefits and harms of PBD compared to direct surgery in patients with obstructive jaundice.

Main Methods:

  • Systematic review of randomized clinical trials comparing PBD followed by surgery versus direct surgery.
  • Searched multiple databases including Cochrane, MEDLINE, and EMBASE until February 2012.
  • Assessed risk of bias and used trial sequential analysis to evaluate the certainty of evidence.

Main Results:

  • Six trials with 520 patients were included; high risk of bias was noted across all trials.
  • No significant difference in mortality was observed between PBD and direct surgery groups.
  • Serious morbidity was significantly higher in the PBD group (73.5%) compared to the direct surgery group (37.4%).

Conclusions:

  • Insufficient evidence exists to support or refute routine PBD for obstructive jaundice.
  • PBD may increase the risk of serious adverse events, and its safety is not established.
  • PBD should not be routinely used outside of randomized clinical trials.