Preoperative Biliary Drainage With Metal Versus Plastic Stents in Periampullary Cancer

Inclusion Criteria: A. Patients 20-80 years old B. Patients with surgically resectable periampullary cancer on CT scans with or without MRI or PET-CT scans C. ECOG Performance score 0 or 1 D. Patients who need preoperative biliary drainage (PBD) because of one or more of following causes * Cholangitis defined as revised Tokyo guidelines * Level of total bilirubin \>= 10mg/dL * Expected time to operation \>= 7 days Exclusion Criteria: A. Patients who received previous endoscopic biliary drainage or percutaneous biliary drainage B. Patients with acute pancreatitis before PBD C. Patients with bleeding tendency or coagulopathy or anticoagulation therapy as follows: * Patients who take clopidogrel within 5 days before PBD * Patients who take warfarin within 2 days before PBD * Patients who receive heparin within 1 days before PBD D. Patients with pregnancy or suspected pregnancy E. Patients who are currently enrolled in another investigational trials that would directly interfere with current study