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Updated: May 27, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Improvement of percutaneous transhepatic biliary internal-external drainage and its initial experience in patients
Huanzhang Niu1, Wanqin Gao, Jingliang Cheng
1The Department of Imaging and Nuclear Medicine, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Background/Aims:
To evaluate the feasibility and clinical results of modified percutaneous transhepatic biliary internal-external drainage (PTBIED) vs. conventional PTBIED in patients with malignant biliary obstruction.
Methodology:
Conventional PTBIED was modified by applying side-holes to an 8.5Fr external biliary drainage catheter. Eligible patients were randomly assigned 1:1 by the doctors to receive modified PTBIED (group A) or conventional PTBIED (group B). Technical success rate, complications, hepatic function and white cell count were recorded pre- and post-procedure. All patients were followed-up until death.
Results:
Twenty-two patients were assigned in group A and 21 patients were involved in group B. Successful drainage was all achieved in both groups. Biliary tract infections were significantly reduced in group A (1/22) compared to group B (7/21, p<0.05). The leukocyte count fell slightly in group A post-procedure, while it rose in group B (group A: 8.45±3.22-109/L to 7.53±2.46-109/L; group B: 7.92±3.08-109/L to 10.52±5.09-109/L). Both procedures had similar effects in the recovery of hepatic function, median survival time and alleviating clinical symptoms (such as pruritis and abdominal pain).
Conclusions:
Modified PTBIED can reduce the complications resulting from retrograde reflux of duodenal contents. Improved PTBIED should be used for patients with inoperable high malignant biliary obstruction.
