Preoperative Biliary Drainage: Methods, Advantages, and Complications

Malignant biliary obstruction is very difficult to treat; only 10–20% of the patients are suitable for curative resections. Obstructive jaundice is associated with a pro-inflammatory state, altering the normal physiology and affecting multiple organ systems. So, patients with malignant obstructive jaundice are at increased risk of postoperative complications. Nevertheless, the preoperative biliary drainage (PBD) remains controversial, because the procedures themselves can be associated with septic and other complications. The main therapeutic options for PBD in malignant biliary obstruction are percutaneous biliary drainage and endoscopic biliary drainage. The knowledge of the approaches, their advantages, and complications are essential for the management of patients with pathologies that produce biliary obstruction such as bile duct cancer. The aim of this chapter is to review the methods for biliary drainage and its indications, advantages, and complications.