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February 1979

Percutaneous Decompression of Benign and Malignant Biliary Obstruction

Author Affiliations

From the Departments of Surgery (Drs Pollock, Mullen, and Rosato) and Radiology (Drs Ring, Oleaga, and Freiman), University of Pennsylvania School of Medicine, and the Philadelphia Veterans Administration Hospital, Philadelphia.

Arch Surg. 1979;114(2):148-151. doi:10.1001/archsurg.1979.01370260038005

• Percutaneous transhepatic catheterization of the biliary tree was performed in 41 patients with obstructive jaundice. In 39 patients, the catheter was successfully advanced past the obstructing lesion into the distal common duct and duodenum to establish internal biliary drainage. The remaining two patients had the obstructed biliary tract drained externally. Chronic internal catheter drainage was instituted in five patients with stricture and ten with malignant obstruction as a means of palliating symptomatic jaundice. Twenty-two patients had marked reduction in serum bilirubin levels and pruritis, eight patients had moderate decreases in serum bilirubin levels, and six patients did not improve despite adequate catheterization due to hepatic parenchymal disease. This procedure effectively decompresses the severely obstructed biliary tree prior to surgery and can also palliate patients with unresectable malignant biliary obstruction and stent high-risk, benign strictures.

(Arch Surg 114:148-151, 1979)