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Preoperative Management of Jaundice

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Textbook of Pancreatic Cancer

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Abstract

Obstructive jaundice occurs in many patients with pancreatic head cancers. While routine preoperative biliary drainage was practiced in 1980s and 1990s, mounting evidence highlighting the risks of preoperative biliary drainage on surgical outcomes has raised questions about the advisability of routine drainage. Today, selective endoscopic drainage is preferred, most often using a Self-Expanding Metallic Stent (SEMS). This chapter will provide the reader with a detailed overview of preoperative biliary drainage for resectable pancreatic head cancer addressing various aspects including its history, rationale and indications, technical variations with respective advantages and disadvantages.

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Acknowledgements

The authors acknowledge the work of Eric Lum, Medical Artist, Flinders Medical Centre, Adelaide—South Australia on the illustration of Fig. 41.3 in the chapter.

Conflict of Interests: None to declare.

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Authors and Affiliations

  1. Division of Surgery and Perioperative Medicine, Flinders Medical Centre, Adelaide, SA, Australia

    Savio George Barreto

  2. College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia

    Savio George Barreto

  3. HBP/Upper GI Unit, Department of General Surgery, Auckland City Hospital, Auckland, New Zealand

    John A. Windsor

  4. Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

    John A. Windsor

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  1. Savio George Barreto
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Correspondence to Savio George Barreto .

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  1. Stavanger University Hospital, The University of Bergen, Bergen, Norway

    Kjetil Søreide

  2. Chirurgie (VTT), Innsbruck Medical University, Innsbruck, Tirol, Austria

    Stefan Stättner

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Barreto, S.G., Windsor, J.A. (2021). Preoperative Management of Jaundice. In: Søreide, K., Stättner, S. (eds) Textbook of Pancreatic Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-53786-9_41

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