Abstract
Jaundice caused by extra hepatic biliary obstruction can improved by percutaneus transhepatic biliary drainage (PTCD). In patients with carcinoma of the pancreas or biliary duct, PTCD is helpful ajunct in preparation for elective surgical procedure. In inoperable cancers of the hepato-biliary system, endoscopic biliary drainage using ERCP and endoscopic sphinctoro papillotomy (EPT) has been tried with success. Recently, we have succeeded in establishing internal biliary drainage by preliminary percutaneus transhepatic cholangio drainage (PTCD) followed by insertion of a permanent drainage tube through ERCP method ; this catheter can be placed proximal to the site of obstruction and the distal end of the tube remains in the duodenum. Endoscopic papillotomy is necessary before the permanent tube is inserted through the common bile duct channel. We believe this to be the only noninvasive approach available, in the management of advanced carcinoma of the biliary tree.
