Abstract
Preoperative biliary drainage (PBD) has been conventionally performed in patients with obstructive jaundice prior to pancreaticoduodenectomy (PD). However, recently, there have been some reports suggesting that PBD might be associated with an increased incidence of postoperative morbidities. It has been argued that PBD induces biliary infection and consequently leads to infectious morbidities such as wound infection. In addition, some reports have suggested that preoperative biliary infection is associated with a risk of pancreatic fistula formation, which can be a life-threatening complication. Therefore, perioperative infection control measures, such as administration of a broad-spectrum antifungal agent, may be necessary to prevent postoperative morbidities in patients undergoing PBD prior to PD. In this report, we review the merits and demerits of PBD before PD and the associations between preoperative biliary infections and postoperative morbidities, including pancreatic fistula formation.
