[Transcutaneous endobiliary interventions in mechanical jaundice]

The authors analyse experience in the treatment of 132 patients with obstructive jaundice which was caused by a neoplastic lesion in 61 and by a benign disease in 71 of them. Bearing in mind the serious condition of this category of patients and the high risk of the operative intervention, two-stage treatment is applied with preliminary decompression of the biliary system and restoration of the main hepatic functions in the first stage. Transcutaneous endo-biliary interventions are carried out when other sparing methods cannot be accomplished or are ineffective. The authors give an integral, finer evaluation of the functional condition of the liver, elimination of the biliary microflora, and in this manner develop the criteria of the indications for the second stage of the intervention (prolonged bile passage in the intestine). In view of the high risk of the operative intervention, the authors suggest wider use of the methods of transcutaneous endo-biliary interventions according to indications. Nine patients died (6.8% mortality) in increasing hepatorenal insufficiency with growth of the oncological process.