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Preoperative Biliary Drainage with Metal Stent Versus Early Surgery in Patients with Pancreatic Cancer: A Randomized Clinical Trial - PubMed

3 hours ago
  • #Randomized Trial
  • #Pancreatic Cancer
  • #Biliary Drainage
  • The trial compared preoperative biliary drainage (PBD) with self-expanding metal stents (SEMS) versus early surgery in patients with pancreatic cancer and biliary obstruction.
  • It was a noninferiority randomized controlled trial involving 284 patients across 11 centers in 9 countries.
  • Primary outcome: Serious adverse events at 120 days were 29.0% in the PBD group and 26.5% in the early surgery group, showing noninferiority of PBD with SEMS.
  • Secondary outcomes: High rate of SEMS insertion (97.2%) and curative-intent surgery in both groups (PBD: 82.6%, early surgery: 92.9%), with similar mortality rates (PBD: 7.9%, early surgery: 8.0%).
  • Conclusion: PBD using SEMS is noninferior to early surgery in safety for pancreatic or periampullary cancer patients with obstructive jaundice.