Abstract
Percutaneous transhepatic retrograde biliary drainage (PTRBD) was performed in 12 patients with biliary malignant obstruction (consisted of extrahepatic bile duct carcinoma in 11 and papilla Vater carcinoma in one patient. ) All patients had had the biliary radicles not nicely drainaged with previous PTBD in the opposite lobe. In those patients, the biliary duct was selectively catheterized using an angiographic catheter and radifocus guidewire inserted through the PTBD sinus tract previously produced. And then, a stiff guidewire was reintroduced pheripherally, to perforate the wall of the biliary radicle, liver parenchyma, and liver capsule, into the abdominal cavity, retrogradely. A guidewire was captured with forceps under fluoroscopy and brought out through the abdominal wall. After subsequent dilatation of percutaneous tract was done along the guidewire extracted PTBD tube was placed in the biliary tract.
PTRBD was useful method for creating the route of PTCS, intraluminal irradiation and expandable metallic stenting. And no significant compliacation was observed in this series.PTRBD was feasible method of creating second route especially in the patients with biliary trees which should be decompressd.
