Percutaneous transhepatic drainage of the biliary tract: technique and results in 104 cases

A two-step procedure for percutaneous transhepatic drainage (PTD) of the biliary tract is described. This technique was applied on a total of 105 cases of obstructive jaundice, 84 with malignant and 21 with benign lesions, and was successful in 104. Decompression effect was adequate and reduction in serum bilirubin level was quick. Operative mortality, which used to be high in jaundiced patients with serum bilirubin levels above 10 mg per dl, has been significantly reduced with this procedure employed as the first step in a two-stage operation for malignant biliary obstruction. PTD proved to be very useful in the management of acute obstructive suppurative cholangitis and ensuing liver abscesses. Continuous drainage was also achieved by PTD in inoperable cases, and 1 patient with a hilar carcinoma was kept alive for 2 years and 1 month by PTD alone. With the improvement in the diagnosis of biliary tract disease this procedure will assume an important position in the management of obstructive jaundice.