Zhang GQ, et al. – Aim of this study is to compare the outcomes of preoperative endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) in patients with malignant distal biliary obstruction prior to pancreaticoduodenectomy (PD). For patients with malignant distal biliary obstruction prior to PD, ENBD is an optimal method. In terms of patient tolerance and the effect of biliary drainage, ERBD is superior to ENBD but is correlated with an increased risk of EBD procedure–related cholangitis and deep abdominal infection after PD.