Technique and management of percutaneous transhepatic cholangial drainage for treating an obstructive jaundice

The authors report on the experience they have gained with regard to the techniques and management of percutaneous transhepatic cholangial drainage (PTCD) as a non-operative method for providing biliary drainage in treating 1,012 patients with obstructive jaundice.

The PTCD puncture for drainage was performed under fluoroscopic guidance for 603 patients between January 1968 and October, 1980, and under ultrasonic guidance for 409 patients between August, 1978 and July, 1994.

The incidence of complications after the fluoroscopically-guided puncture was 6.0%, the early post-PTCD complications consisting of hemobilia(5 patients), shock due to an increased the intrabiliary pressure following an injection from the contrast material (12 patients), and shock due to a decrease in the intrabiliary pressure (13 patients), and the late complications consisting of bile peritonitis caused by catheter displacement (6 patients). In contrast, the incidence of post-PTCD complications after the ultrasonically-guided puncture amounted to only 0.7%, which was dramatically lower, and the only complication that occurred was a late complication due to PTCD-tube displacement.

Thus, monitoring the PTCD-tube is important to complete recovery from the PTCD procedure.