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Background: Self expandable metal stents (SEMS) are usually reserved for patients with inoperable malignant biliary obstruction. Aim: Compare the clinical outcomes of patients with pancreatic cancer who underwent plastic or self expandable metal stent (SEMS) placement and subsequently underwent a Whipple’s procedure. Methods: This is a retrospective single center study of all patients with pancreaticobiliary malignancy who underwent Whipple’s procedure by one surgeon over a 4 year period. Patients who underwent preoperative endoscopic biliary decompression at the same institution were identified. All ERCP’s were performed by two endoscopists and the type of stent (metal vs. plastic) deployed was based on the discretion of the endoscopist. Plastic stents were 10Fr in diameter and varied between 7-9 cm in length; SEMS were 10Fr in diameter, 6 cm in length, and were placed below the line of any potential surgical transection. The clinical course of these patients following stent placement and until surgery were reviewed. Results: 30 of 270 (11%) patients who underwent Whipple’s procedure had a preoperative ERCP with biliary stent placement. Twenty patients had plastic and 10 had SEMS placements. The mean duration to surgery following SEMS and plastic stent placements were 71 and 90 days (p= NS), respectively. While none of the 10 patients who underwent SEMS placement required a repeat intervention, 8 of 20 patients with plastic stents required 10 endoscopic interventions prior to surgery (p=0.04). Of the 8 patients who required a repeat intervention, 3 required hospitalization for cholangitis (mean length of stay 4 days, range [3-5]). Three patients with SEMS and 2 with plastic stent placements underwent preoperative chemoradiation and EUS-guided FNA that yielded a positive tissue diagnosis in all cases; SEMS did not impair visualization of the tumor mass at EUS. A Whipple’s resection was undertaken successfully in all 30 patients and the presence of a SEMS caused no interference with biliary anastomosis. Conclusions: In this study, there was less need for repeat endoscopic interventions prior to a Whipple’s procedure when a SEMS was placed initially for biliary decompression. Also, the presence of a SEMS did not preclude preoperative chemoradiation, EUS-guided FNA, or pose technical challenges at surgery.