Current Indications for Percutaneous Transhepatic Biliary Drainage

Abstract

Recently, percutaneous transhepatic biliary drainage (PTBD) has been replaced by endoscopic biliary drainage (EBD) as the mainstream procedure for biliary drainage. Among the 136 cases of PTBD at our hospital during the last 6 years, the procedure was performed post bilioenteric reconstruction in 65 (47.8%) patients, for selective drainage of the peripheral intrahepatic bile ducts in 43 (31.6%) patients, and because of poor results obtained by endoscopic therapy in 28 (20.6%) patients. The current indications of PTBD converge with the contraindications for EBD, such as incomplete reaching for ampulla or peripheral bile ducts, or inefficiency of endoscopic therapy, and that will be more limited with the development of new endoscopic devices such as double-balloon endoscopes. Although under this situation, the clinical importance of PTBD is still remain because this procedure needs more reliability for individual patient compared with before. How to improve and maintain the crucial PTBD technique is an issue that needs to be resolved in the future.