Transhepatic intubation of the common bile duct for inoperable obstruction—experience with 20 cases

Abstract

The problems associated with the establishment of permanent bile drainage in the presence of inoperable bile duct obstructions are discussed, and the possibility of achieving effective drainage by means of an in‐dwelling transhepatic tube is described. Such a tube may be left in situ for the remainder of the life of patients suffering from carcinoma or indefinitely in patients suffering from nonmalignant obstructions. The techniques involved in the different circumstances are described. Certain special instruments have been made to facilitate introduction of the tube, and a description of these instruments and their use is given. A few representative case histories are given in which the various procedures were employed.

Relief of Inoperable Malignant Obstructive Jaundice following the Conversion of Percutaneous Transhepatic Bile Drainage to Internal Drainage

“…Technique for the conversion of PTCD to internal drainage: techniques used for PTCD and external drainage in this study were essentially the same as described by several investigators [1][2][3][4][5]. Internal drainage was usually indicated 7-10 days after PTCD had alleviated persistent cholestasis.…”

“…PTCD is partic ularly important as a palliative maneuver for the treat ment of malignant biliary tract obstruction [1][2][3]. How ever, patients with incurable malignant obstruction of the biliary tree always experience significant problems as a result of total bile drainage, including water-electro lyte imbalances and poor digestion and absorption in the absence of bile juice in the intestinal tract.…”