[Preoperative drainage of the biliary tract in patients with obstructive jaundice]

The authors present their experience with preoperative external-internal percutaneous transhepatic drainage of the biliary pathways (PTD) in 143 patients. From this group in the final stage 53 patients were operated. The authors discuss the contemporary position and importance of preoperative PTD and compare the advantages of external-internal PTD and external drainage of the biliary pathways. A rapidly performed and correctly indicated external-internal PTD reduces effectively within several days the patient's bilirubin level, the bile passes into the duodenum, dehydration of the organism does not occur and vitamin K absorption is not impaired. All this has an impact on the success of surgery. Moreover, the external-internal drain modified in a suitable way surgical tactics and ensured effective drainage of the biliary pathways during the early postoperative period. If radical surgery is impossible, it is feasible as a suitable alternative procedure of palliative surgery to insert by the percutaneous route an expansible metal stent or leave the external-internal PTD drain in situ for a prolonged period. The authors discuss the criteria for indication, analyze the main problems of this procedure and submit their results.