THE TECHNIQUE AND MANAGEMENT OF PERCUTANEOUS TRANSHEPATIC CHOLANGIAL DRAINAGE FOR TREATING AN OBSTRUCTIVE-JAUNDICE

Background/Aims: The authors report on the experience they have gained with regard to the techniques and management of percutaneous transhep atic cholangial drainage (PTCD) as a non-operative method for providin g biliary drainage in treating 1,012 patients with obstructive jaundic e. Materials and Methods: The PTCD puncture far drainage was performed under fluoroscopic guidance for 603 patients between January, 1968 an d October, 1980, and under ultrasonic guidance for 409 patients betwee n August, 1978 and July, 1994. Results: The Incidence of complications after the fluoroscopically-guided puncture was 6.0%, the early post-P TCD complications consisting of hemobilia (5 patients), shock due to a n increased the intrabiliary pressure following an injection from the contrast material (12 patients), and shock due to a decrease in the in trabiliary pressure (13 patients), and the late complications consisti ng of bile peritonitis caused by catheter displacement (6 patients). I n contrast, the incidence of post-PTCD complications after the ultraso nically-guided puncture amounted to only 0.7%, which was dramatically lower, and the only complication that occurred was a late complication due to PTCD-tube displacement. Conclusion: Thus, monitoring the PTCD- tube is important to complete recovery from the PTCD procedure.