Work in progress: hypotension and high-volume biliary excretion following external percutaneous transhepatic biliary drainage.

A review of 120 consecutive percutaneous transhepatic biliary drainage (PTBD) procedures performed for high-grade obstructive jaundice identified seven patients whose bile output exceeded normal volumes. Three patients required intense fluid therapy for intravascular volume depletion. No patient exhibited fever or bacteremia. Hypovolemia due to high-volume biliary drainage was considered responsible for severe hypotension. Hypovolemia secondary to large-volume biliary secretion may complicate PTBD. The pathophysiology of high-volume biliary drainage unrelated to initial decompression is uncertain.