Percutaneous transhepatic biliary drainage: technique, results, and applications.

Internal catheter drainage was achieved in 46 of 62 consecutive patients (71.4%) undergoing percutaneous transhepatic biliary drainage (PTHBD). External drainage was achieved in 12 patients (19.3). Thus the overall success rate was 58 of 62 (93.5%). Postprocedural bilirubin levels returned to normal in 14 cases (22.5%), while bilirubin declines greater than 10 mg resulted in half the cases. Complications related to procedures occurred in three patients, although no deaths resulted. Late episodes of cholangitis were common (9/62 or 14.5%). Postprocedural care of the biliary drainage catheter included evaluation and management of acute biliary sepsis, persistent hyperbilirubinemia, electrolyte depletion, as well as catheter occlusion, bleeding, and dislodgement. PTHBD offers an effective new radiological alternative to surgical therapy of biliary obstruction.