Abstract
Percutaneous transhepatic biliary drainage (PTBD) was performed 405 times on 346 patients during the period of 1980 to 1987. Our methods of PTBD were as follows.
A method (257 cases): PTBD via the frontal approach using double tube under X-ray control
B method (69 cases): PTBD via the frontal approach using Seldinger's method under US
C method (79 cases): PTBD via the lateral approach using Seldinger's method under US
Dislodgement of the drainage ube occurred in 22 cases (5.4%). The rates of dislodgement of the drainage tube in A, B and C method were 3.9%,0.0% and 15.2% respectively. These rates were not influenced by the position of the drainage tube in the bile duct excepting gallbladder. Bile peritonitis occured in 5 patients. PTBD using B method proved to be very safe from dislodgement of the drainage tube. Therefore, this method would be the preferred procedure, but A method should be chosen in the case with obstruction locating in the right hepatic duct. It seems to be necessary to devise the PTBD tube itself to prevent the dislodgement of it in case of undergoing C method.
