Lately Therapeutic Effect and Impact Factors of Bilateral PTBD in Malignant Hilar Biliary Obstructive Jaundice

Objective To evaluate the therapeutic effect of bilateral percutaneous transhepatic biliary drainage (PTBD) in patients with obstructive jaundice caused by hilar biliary invaded by malignant tumor and to determine the factors effect the threatment outcome. Methods We retrospectively analyzed the data of 27 patients (M∶F=2.38∶1, mean age 52.8 years). Inclusion criteria were the patient having obstructive jaundice that malignant tumor invaded the hilar bile ducts and having at least 4 weeks of follow-up data after the PTBD. We defined response and poor response as whether the level of total bilirubin decreased more than 50% in 4 weeks or not. Total bilirubin level (T-bil), Child-Pugh score,the interval between clinical onset of jaundice and PTBD, the interval between the right and left lobe intervention and the location of biliary obstruction for the two groups were compared. Results Of the 27 patients, 18 (66.7%) showed good response. The interval between clinical onset of jaundice and PTBD, the interval between the right and left lobe intervention show significant effect.the presence of and the size of the tumor did not show significant effect. Conclusion Early and effective biliary drainage might be necessary in this group of patients.