Percutaneous transhepatic biliary drainage: technique, results, and applications.

Abstract

Internal catheter drainage was achieved in 46 of 62 consecutive patients (71.4%) undergoing percutaneous transhepatic biliary drainage (PTHBD). External drainage was achieved in 12 patients (19.3%). The overall success rate was 58 of 62 (93.5%). Postprocedural bilirubin levels returned to normal in 14 cases (22.5%); bilirubin declined greater than 10 mg in half the cases. Complications related to procedures occurred in 3 patients, although no deaths resulted. Late episodes of cholangitis were common (9/62 or 14.5%). Postprocedural care of the biliary drainage catheter included evaluation and management of acute biliary sepsis, persistent hyperbilirubinemia, electrolyte depletion, catheter occlusion, bleeding and dislodgement. PTHBD offers an effective new ragiological alternative to surgical therapy of biliary obstruction.