Anton Vavrečka, Daniel Pinďák, Juraj Pechan
Malignant tumors of the biliary tract and pancreatic head lead to biliary obstruction, which is clinically manifested as jaundice, cholestasis, or even cholangitis. Jaundice and cholestasis can be removed endoscopically with stent implantation or surgically by bypass and the treatment could be supported with chemotherapy. But these are highly palliative procedures which are applicable only for inoperable cancers. The basis of treatment is surgical removal of the tumor resectability of which is supposed. The question is whether in patients with operable malignancies should drainage be carried out before the operation or not. The view that the removal of jaundice and cholestasis with stent reduces the number of operative and postoperative complications is not generally accepted. The findings are published that routine preoperative drainage does not reduce the number of postoperative complications, but rather increases them. The article summarizes the current views of various work places on the subject and at the same time our own opinion based on experience gained in performance over the 10 000 endoscopic retrograde cholangiopankreaticographies.