Percutaneous transhepatic biliary drainage for the treatment of obstructive jaundice caused by metastases from nonbiliary and nonpancreatic cancers.

The usefulness of percutaneous transhepatic biliary drainage (PTBD) in the treatment of obstructive jaundice caused by metastases from nonbiliary and nonpancreatic cancers was evaluated. Eighteen patients underwent PTBD during a 3-year period. The primary cancers were located in the stomach (nine cases), colon (four), lung (three), uterus (one), and breast (one). The causes of obstructive jaundice and bile duct strictures were investigated using both abdominal computed tomography and abdominal ultrasonography. The causes of obstructive jaundice, the usefulness of PTBD in terms of the relief of symptoms and laboratory data, survival after PTBD, and the relationship between patient characteristics and survival were evaluated. Obstructive jaundice was most often attributable to metastases to the lymph nodes (17 of 18 cases). One case was attributed to metastasis to the liver. PTBD decreased the jaundice and relieved the symptoms caused by biliary tract obstruction. Median survival after PTBD was 59 days. Patients whose performance status was 2 or less survived longer than those with a performance status of 3 or more (P=0.018). Furthermore, patients aged less than 60 years tended to survive longer than those aged 60 or over (P=0.057). Our results suggest that PTBD is useful for relief of symptoms caused by obstructive jaundice in patients with nonbiliary and nonpancreatic cancers.