The effect of percutaneous transhepatic biliary drainage combined with biliary stent in the treatment of malignant upper biliary tract obstruction in 12 cases

Objective: To explore the effects of percutaneous transhepatic biliary drainage(PTBD) combined with biliary stent in the treatment of malignant upper biliary tract obstruction.Methods: Stents were implanted into 12 patients by unilateral or bilateral puncture.The single stent was implanted into the ductuli hepaticus communis in 7 cases.The stents were implanted into the left and right hepatic duct through bilateral hepatic duct puncture in 3 cases at the same time.The stents were implanted into between the 1eft and right hepatic duct and between the hepatic duct and the common bile duct through unibilateral hepatic duct puncture in 2 cases.Results: Twelve operations were successful.The jaundice of all patients alleviated or disappeared obviously after implantation.After 7 d total bilirubin,direct bilirubin,alkaline phosphatase,alanine aminotransferase,γ-glutamine transaminase levels before treatment difference was statistically significant(P 0.05-P 0.01).One case with stent obstruction was found in 4 months after operation,who were treated with secondary intervention.One case with duodenal obstruction was found in 6 months after implanting sent into biliary tract,who was treated with stent in duodenum.Conclusions: Implanting stent into different bile duct for treating malignant upper biliary tract obstruction is safe,reliable and good effects.