The effect of pre-operative biliary drainage in resectable periampullary lesions: a systematic review and meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Pre-operative biliary drainage (PBD) before pancreaticoduodenectomy (PD) does not improve outcomes and increases complications, including wound infections. Avoid routine PBD, especially for patients with low bilirubin levels.
Area Of Science
- Gastroenterology and Hepatology
- Surgical Oncology
- Evidence-Based Medicine
Background
- The role of pre-operative biliary stenting in pancreaticoduodenectomy (PD) is debated.
- Complications following PD can be significant, impacting patient recovery.
Purpose Of The Study
- To evaluate the impact of pre-operative biliary drainage (PBD) on post-operative complications after PD.
- To determine if PBD offers any benefit in surgical outcomes.
Main Methods
- A comprehensive meta-analysis was performed, adhering to PRISMA guidelines.
- Searched PubMed, Web of Science, and Ovid databases up to February 2023.
- Included 35 retrospective studies and 2 RCTs, totaling 12,641 patients.
Main Results
- Pre-operative biliary drainage (PBD) was associated with a significantly higher overall complication rate (OR 1.46).
- Increased incidence of delayed gastric emptying (OR 1.21) and wound infections (OR 2.2) observed in the PBD group.
- No beneficial effect of PBD on post-operative outcomes was found.
Conclusions
- Pre-operative biliary drainage (PBD) does not confer benefits for post-operative outcomes in PD patients.
- Routine PBD should be avoided, particularly in patients with total bilirubin < 250 umol/L.
- Further research into precise indications for PBD is warranted.
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