Interventional therapy of malignant obstructive jaundice

Objective:To explore the value of percutaneous transhepatic biliary drainage(PTBD) for the treatment of the malignant obstructive jaundice.Methods:One hundred and fifteen cases of the malignant obstructive jaundice were enrolled in this study. All patients were diagnosed as malignant obstructive jaundice with CT,MRI,B-ultrasonography and biochemical examination. Of them,66 cases were male,49 cases female,the average age 59.2±10.6. The successful rate of PTBD was 100%. The punctures were guided under fluoroscopy to the right hepatic duct in 107 cases. The other 8 cases were guided under the B-ultrasonography to puncture the hepatic duct.Results:The metallic stents were inserted in one step and with internal and external drainage in 86 cases;29 cases were treated initially with external drainage,and the metallic stents were inserted with two steps method after 1～2 weeks' external drainage in 23 of 29 patients. The other 6 cases were undergone continuously external drainage. Serum total bilirubin level was obviously descended after the metallic stent was inserted and drainage was performed. The general condition of the patient was obviously improved,serum GPT was remarkably decreased. The occurrence rate of the complication was 15.65%. Their symptoms subsided after treatment.Conclusion:PTBD is a reliable and effective method in the treatment of the malignant obstructive jaundice. The external or internal drainage method were selected according to the position and degree of the obstruction in clinical work.