title: Does preoperative biliary drainage compromise the long-term survival of patients with pancreatic head carcinoma?
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  Medical 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.
  
  
  RESULTS
  Overall 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).
  
  
  CONCLUSIONS
  PBD may not affect the long-term survival of patients with pancreatic head carcinoma if ERBD is used.
authors.affiliation: Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Naru
authors.initials: N
authors.lastname: Kondo
authors.forename: Naoya
authors.initials: N
authors.lastname: Nakagawa
authors.forename: Hayato
authors.initials: H
authors.lastname: Sasaki
authors.forename: Naoto
authors.initials: N
authors.lastname: Hatano
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kohmo
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001659:Biliary Tract / Q000473:pathology*; D001662:Biliary Tract Surgical Procedures / Q000401:mortality*; D004322:Drainage / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care; D011379:Prognosis; D015996:Survival Rate
keywords: endoscopic retrograde biliary drainage; long-term survival; pancreatic head carcinoma; percutaneous transhepatic biliary drainage; preoperative biliary drainage