Shepherd 1988.

Methods	RCT
Participants	Malignant obstruction of distal bile duct Not suitable for curative surgery Technically suitable for surgical bypass 78% had pancreatic cancer
Interventions	Surgical bypass 10Fr polyethylene stent Cephalosporins
Outcomes	Technical success Median duration of hospital stay for those alive > 30 days Number of patients alive > 30 days 30‐day mortality Procedural complications Overall survival in days Relief of jaundice Number of re‐admissions Total hospital stay
Notes	N =52
Risk of bias
Bias	Authors' judgement	Support for judgement
Adequate sequence generation?	Unclear risk	Not described
Allocation concealment?	Unclear risk	Not described
Blinding? All outcomes	High risk
Incomplete outcome data addressed? All outcomes	Low risk	All described
Free of selective reporting?	Low risk	All outcomes described