EXTERNAL BILIARY JEJUNAL DRAINAGE THROUGH A PERCUTANEOUS ENDOSCOPIC GASTROSTOMY FOR TUBE-FED PATIENTS WITH OBSTRUCTIVE-JAUNDICE

We describe a new procedure, which can help patients with obstructive jaundice improve their quality of life (QOL). Although percutaneous tr anshepatic biliary drainage (PTBD) can relieve jaundice, the procedure has some disadvantages. Percutaneous endoscopic gastrostomy (PEG) is a useful method for providing nutritional support to patients unable t o swallow. We have combined these two techniques. We used the combinat ion of a 20-F catheter and a 9-F jejunal catheter for PEG. The PTBD ca theter and the 9-F jejunal catheter are connected outside the patient' s body. Externally drained bile from the PTBD catheter can flow back i nto the jejunum, and the opening between the 20-F catheter and the 9-F jejunal catheter is used for tube feeding. This procedure was adopted in a patient. Since the procedure, the patient's nutritional status a nd daily living activities have improved. We conclude that the procedu re is useful for tube-fed patients with obstructive jaundice.