[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
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
Abstract

• 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)

References
1.
Okuda K, Tanikawa K, Emura T, et al:  Nonsurgical percutaneous transhepatic cholangiography: Diagnostic significance in medical problems of the liver . Am J Dig Dis 19:21-36, 1974.Article
2.
Redecker A, Karvountgis GG, Richman RH, et al:  Percutaneous transhepatic cholangiography: An improved technique . JAMA 231:386-387, 1975.Article
3.
Molnar W, Stockman AE:  Relief of obstructive jaundice through percutaneous transhepatic catheter: A new therapeutic method . Am J Roentgenol 122:356-367, 1974.Article
4.
Tylen V, Hoevels J, Vang J:  Percutaneous transhepatic cholangiography with external drainage of obstructive biliary lesions . Surg Gynecol Obstet 144:13-18, 1977.
5.
Mori K, Misumi A, Suguyama M, et al:  Percutaneous transhepatic bile drainage . Ann Surg 185:111-115, 1977.Article
6.
Nakayama T, Ikeda A, Okuda K:  Percutaneous transhepatic drainage of the biliary tract . Gastroenterol 74:554-559, 1978.
7.
Burcharth F:  A new endoprosthesis for nonoperative intubation of the biliary tract in malignant obstructive jaundice . Surg Gynecol Obstet 146:76-78, 1978.
8.
Ring EJ, Oleaga JA, Freiman DB, et al: Therapeutic applications of catheter cholangiography. Radiology, to be published.
9.
Ferruci JT, Wittenberg J, Sarno RA, et al:  Fine needle transhepatic cholangiography: A new approach to obstructive jaundice . Am J Roentgenol 127:403-407, 1976.Article
10.
Shapiro TM:  Adenocarcinoma of the pancreas: A statistical analysis of biliary bypass vs Whipple resection in good risk patients . Ann Surg 182:715-721, 1975.Article
11.
Crile G Jr:  The advantages of bypass operations over radical pancreatoduodenectomy in the treatment of pancreatic carcinoma . Surg Gynecol Obstet 130:1049-1053, 1970.
12.
Feduska NJ, Dent TL, Lindenauer SM:  Results of palliative operations for carcinoma of the pancreas . Arch Surg 103:330-334, 1971.Article
13.
Hertzburg J:  Pancreatico-duodenal resection and bypass operation in patients with carcinoma of the head of the pancreas, ampulla and distal end of the common duct . Acta Chir Scand 140:523-527, 1974.
14.
Buckwalter JA, Lawton RL, Tidrick RT:  Bypass operations for neoplastic biliary tract obstruction . Am J Surg 109:100-106, 1965.Article
15.
Webster JT:  Carcinoma of the pancreas and peri-ampullary region: A clinical study in a district general hospital . Br J Surg 62:130-134, 1975.Article
16.
Gatti DJ, O'Brien PH, Grooms GA:  Analysis of pancreatoduodenectomy . South Med J 67:278-286, 1974.Article
17.
Braasch JW, Gray BN:  Considerations that lower pancreatoduodenectomy mortality . Am J Surg 133:480-484, 1977.Article
18.
Brooks JR, Culebras JM:  Cancer of the pancreas: Palliative operation. Whipple procedure or total pancreatectomy . Am J Surg 131:516-520, 1976.Article
19.
Buranasiri S, Baum S:  The significance of the venous phase of celiac and mesenteric arteriography in evaluating pancreatic carcinoma . Radiology 102:11-20, 1972.Article
20.
Viamonte M, LePage JR, Lunderguist A, et al:  Selective catheterization of the portal vein and its tributaries . Radiology 114:457-460, 1975.Article
21.
Forsgren L, Urell S:  Aspiration cytology in carcinoma of the pancreas . Surgery 73:38-42, 1973.
22.
Braasch JW, Warren KW, Blevens PK:  Progress in biliary stricture repair . Am J Surg 129:34-37, 1975.Article
23.
Smith R:  Hepaticojejunostomy with transhepatic intubation: A technique for very high strictures of the hepatic ducts . Br J Surg 51:186-194, 1964.Article
24.
Stone RM, Cohen Z, Taylor BR, et al:  Bile duct injury: Results of repair using a changeable stent . Am J Surg 125:253-256, 1973.Article
×