Percutaneous biliary decompression: internal and external drainage in 50 patients.

A review of percutaneous biliary decompression performed at the Mayo Clinic was initiated to study indications, technique, technical problems, and short- and long-term complications. Data were collected on the initial 50 patients in whom biliary decompression had been performed. More than 80% of patients presented with lesions or a record of previous surgery near the ductal bifurcation that resulted in increased difficulty in obtaining internal drainage. Follow-up data were available in 40 patients and allowed careful evaluation of immediate and long-term complications. Significant complications were limited to intraabdominal bleeding, which occurred in four patients and resulted in death in one. Four patients experienced sepsis immediately after the procedure, and episodes of cholangitis occurred in seven patients who had long-term drainage catheters in place.