PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE FOR THE TREATMENT OF OBSTRUCTIVE-JAUNDICE CAUSED BY METASTASES FROM NONBILIARY AND NONPANCREATICCANCERS

The usefulness of percutaneous transhepatic biliary drainage (PTBD) in the treatment of obstructive jaundice caused by metastases from nonbi liary and nonpancreatic cancers was evaluated. Eighteen patients under went PTBD during a 3-year period. The primary cancers were located in the stomach (nine cases), colon (four), lung (three), uterus (one), an d breast (one). The causes of obstructive jaundice and bile duct stric tures were investigated using both abdominal computed tomography and a bdominal ultrasonography. The causes of obstructive jaundice, the usef ulness of PTBD in terms of the relief of symptoms and laboratory data, survival after PTBD, and the relationship between patient characteris tics and survival were evaluated, Obstructive jaundice was most often attributable to metastases to the lymph nodes (17 of 18 cases). One ca se was attributed to metastasis to the liver. PTBD decreased the jaund ice and relieved the symptoms caused by biliary tract obstruction. Med ian survival after PTBD was 59 days. Patients whose performance status was 2 or less survived longer than those with a performance status of 3 or more (P=0.018). Furthermore, patients aged less than 60 years te nded to survive longer than those aged 60 or over (P=0.057). Our resul ts suggest that PTBD is useful for relief of symptoms caused by obstru ctive jaundice in patients with nonbiliary and nonpancreatic cancers.