[Percutaneous transhepatic drainage of the bile ducts]

Percutaneous transhepatic biliary duct drainage followed in nearly one quarter of the group of patients with percutaneous transhepatic cholangiography for malignant and non-malignant diseases. A total of 147 drainage operations were performed, thereof 126 (85.7%) successful ones. Drain was successfully introduced in 96 (88.2%) out of 107 patients. In 78 patients, successful or unsuccessful attempts were made once, in 19 cases drainage was performed twice, and in 9 cases three attempts were made. In 1 female patient the attempt had to be repeated 4 times. There were 11 cases of complication in connection with the puncture proper (7.5%), 2 cases required emergency laparotomy, the rest were handled conservatively. There was no lethal complication. In one quarter of the drains introduced, complete loss of function occurred in the course of drainage (slipped-out drain, block). Septic complications threatened unless drainage was restored in time. Proper management of the catheter in place is crucial for the uncomplicated course of drainage. Also important are the patient's cooperation and the nursing personnel's experience. Internal drainage was used in 15 cases. An endoprosthesis was introduced transcutaneously in 1 case. The longest functional drainage ina case of malignant involvement lasted 288 days, in a non-malignant case 330 days and for the next 334 days endoprosthesis was introduced. The average quantity of bile was 1,009 ml/24 hrs. in malignant cases, and 644 ml/24 hrs. in non-malignant cases. The average period of time from the introduction of drainage until surgical operation was 18 days in malignant cases, 11 days in non-malignant cases.(ABSTRACT TRUNCATED AT 250 WORDS)