BILATERAL HEPATIC DUCT DECOMPRESSION VIA A SINGLE PERCUTANEOUS TRACT USING A MOTHER-BABY DRAINAGE CATHETER

Decompression of the right and left hepatic ducts using a 'mother-baby ' self-made drainage system via a single percutaneous tract was perfor med successfully in 15 of 21 patients with benign (n = 4) and malignan t (= 17) hilar obstruction. The 'mother-baby' drainage system was comp osed of an 18 F catheter placed through the right hepatic duct into th e distal common bile duct which was designated as the `mother' cathete r, while a second 10 F baby catheter was placed through the first cath eter into the left hepatic ducts. This was achieved by a three-stage p rocedure: (1) percutaneous transhepatic biliary drainage; (2) balloon dilatation of the tract; and (3) intubation of the contralateral hepat ic duct and placement of the 'mother-baby' drainage catheters. The mea n interval of stent clogging was 5 months, with a range of 2-9 months. In 12 malignant cases, average survival time was 9.8 months. The tech nique avoided a second percutaneous hepatic puncture in centrally obst ructing lesions and afforded bilateral biliary decompression.