BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) is effective in the management of biliary obstruction. PTBD can be used as an alternative to endoscopic approach when it is unavailable or unsuccessful due to anatomical variations or technical difficulty.
OBJECTIVES: To evaluate the success rate, complications, morbidity and mortality in patients with inoperable malignant obstructive jaundice treated with PTBD with or without stenting.
SUBJECTS AND METHODS: 67 percutaneous transhepatic biliary procedures were performed for forty five selected patients with inoperable malignant extrahepatic cholestasis. In total there were 21 male (46.7%) and 24 female (53.3%) patients. The mean age was 69 years and ranged from 48-88 years. These patients were subdivided into three equal groups according to the planned drainage for internal-external drainage, external drainage or metallic stenting. Statistical analysis included Chi square test, values were considered significant when P values ≤0.05.
RESULTS: The overall technical success rate was 83% while the overall therapeutic success was 86.6% with the best results (100%) reported in the group of metallic stenting. There was no procedure related mortality in the different groups. The overall immediate, early and late complications were 20%, 29% and 20% respectively, with the highest complications rate reported in the group of external drainage. The overall 30 days mortality was 26.7% with the highest incidence was reported in the group of external drainage (53.3%).
CONCLUSION: PTBD and stenting offer a safe and effective method in providing palliative treatment for patients with malignant biliary obstruction.
Key Words: Percutaneous transhepatic biliary drainage- Malignant biliary obstruction- Biliary stent