Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5386
Peer-review started: March 23, 2017
First decision: April 21, 2017
Revised: May 3, 2017
Accepted: June 19, 2017
Article in press: June 19, 2017
Published online: August 7, 2017
Processing time: 139 Days and 12.5 Hours
Core tip: To compare the outcomes of preoperative endoscopic biliary drainage via endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in patients with malignant distal biliary obstruction prior to pancreaticoduodenectomy (PD), we studied 153 patients with malignant distal biliary obstruction who underwent ENBD or ERBD prior to PD. ERBD was superior to ENBD in terms of patient tolerance and the effect of biliary drainage, but the incidence rates of endoscopic biliary drainage procedure-related complications and deep abdominal infection after PD were higher than those associated with ENBD. Multivariate analysis showed that ERBD was an independent risk factor for deep abdominal infection after PD. ENBD is the optimal method for patients with malignant distal biliary obstruction prior to PD.