Indications and clinical controversies of preoperative biliary drainage at different anatomical sites in malignant obstructive jaundice

Abstract:

Malignant obstructive jaundice is a severe pathophysiological disorder characterized primarily by hyperbilirubinemia secondary to biliary obstruction. To mitigate the adverse effects of hyperbilirubinemia and reduce postoperative complications, preoperative biliary drainage (PBD) has long been employed as a perioperative management strategy. Nevertheless, whether PBD confers definitive clinical benefits remains a subject of considerable debate. This review systematically summarizes the current literature, with particular emphasis on the indications, approaches, and clinical value of PBD in relation to obstruction at different anatomical sites, aiming to provide evidence-based guidance for surgical decision-making in patients with malignant obstructive jaundice.