[Percutaneous transhepatic intubation of bile ducts for combined internal and external drainage in extrahepatic cholestasis (author's transl)]

Abstract

In 37 patients with extrahepatic cholestasis of different origin, percutaneous transhepatic intubation of the bile ducts was performed for combined internal and external drainage. In 5 cases with stones in the extrahepatic bile ducts and in 12 cases with periampullary tumors, the bile ducts were drained preoperatively. In 3 of these patients, temporary drainage was performed because of postoperative complications. Thirteen patients with non-resectable tumors received a permanent drainage as palliation. In 4 patients temporary drainage was performed during radiation/cytostatic therapy. One patient with an iatrogenic bile duct lesion and one patient with an inflammatory tumor in the liver hilum had a drainage catheter placed because a bile duct resection with creation of a biliodigestive anastomosis was not possible. In one patient with a non-resectable periampullary carcinoma the drainage catheter was replaced by a teflon bile duct endoprosthesis inserted by the percutaneous transhepatic approach. The complications of non-operative percutaneous transhepatic bile drainage are discussed.