SEMS Placement Before Surgery in Unblocking Bile Duct in Patients With Periampullary Pancreatic Cancer With Severe Obstructive Jaundice

Inclusion Criteria: * Diagnosis of operable peri-ampullary pancreatic cancer as determined by the Department of Surgery per their standard of care * Serum bilirubin \> 10 mg/dl * Adequate birth control Exclusion Criteria: * Patients with evidence of distant metastasis on computed tomography (CT) or magnetic resonance imaging (MRI) * Patients anticipated to require vascular reconstruction * Patients with cholangitis * Patients for whom surgery is deemed inappropriate by surgeon * Patients with bilirubin less than 10 mg/dL or greater than 20 mg/dL * Patients who previously underwent biliary decompression for cholangitis by ERCP or percutaneous transhepatic cholangiography (PTC) * Patients with low performance score (Karnofsky performance status scale \< 50) * Patients with known preexisting liver disease with associated elevated bilirubin * Patients who are pregnant or actively breast feeding