Bilateral hepatic duct decompression via a single percutaneous tract using a 'mother-baby' drainage catheter

Decompression of the right and left hepatic ducts using a 'mother-baby' self-made drainage system via a single percutaneous tract was performed successfully in 15 of 21 patients with benign (n = 4) and malignant (= 17) hilar obstruction. The 'mother-baby' drainage system was composed of an 18 F catheter placed through the right hepatic duct into the distal common bile duct which was designated as the 'mother' catheter, while a second 10 F baby catheter was placed through the first catheter into the left hepatic ducts. This was achieved by a three-stage procedure: (1) percutaneous transhepatic biliary drainage; (2) balloon dilatation of the tract; and (3) intubation of the contralateral hepatic duct and placement of the 'mother-baby' drainage catheters. The mean interval of stent clogging was 5 months, with a range of 2-9 months. In 12 malignant cases, average survival time was 9.8 months. The technique avoided a second percutaneous hepatic puncture in centrally obstructing lesions and afforded bilateral biliary decompression.