Gastrointestinal Radiology

, Volume 3, Issue 1, pp 23–31 | Cite as

Percutaneous transhepatic intubation of bile ducts for combined internal-external drainage in preoperative and palliative treatment of obstructive jaundice

  • J. Hoevels
  • A. Lunderquist
  • I. Ihse


Percutaneous transhepatic intubation and combined internal-external drainage of the biliary system was performed in 15 patients with occlusion of the extrahepatic bile ducts due mainly to cholangiocarcinoma, metastases of the hepatoduodenal ligament, and tumors of the periampullary region. The technique is described and the value of the procedure in temporary decompression and combined internalexternal bile drainage prior to radical surgery is demonstrated. Its advantages as a palliative method are evident in far-advanced malignancy when extensive and complicated surgical procedures are ill-advised.

Key words

Obstructive jaundice Percutaneous transhepatic intubation Biliary decompression Preoperative drainage Palliation 


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  1. 1.
    Glenn F, Thorbjarnarson B: Carcinoma of the pancreas.Ann Surg 159:945–955, 1964Google Scholar
  2. 2.
    Sato T, Saitoh Y, Koyama K, Watanabe K: Preoperative determination of operability in carcinomas of the pancreas and the periampullary region.Ann Surg 168:876–886, 1968Google Scholar
  3. 3.
    Schmidt HD, Rückert R, Brünner H: Malignant obstructive jaundice (in German).Z Gastroenterol 15:89–98, 1977Google Scholar
  4. 4.
    Feduska NJ, Dent ThL, Lindenauer SM: Results of palliative operations for carcinoma of the pancreas.Arch Surg 103:330–333, 1971Google Scholar
  5. 5.
    Heydenrych JJ, van Zijl FD du T, van Zyl JJW: Transhepatic intubation of the common bile duct for inoperable obstruction. Experience with 20 cases.J Surg Oncol 1:63–75, 1969Google Scholar
  6. 6.
    Praderi RC: Twelve years' experience with transhepatic intubation.Ann Surg 179:937–940, 1974Google Scholar
  7. 7.
    Terblanche J, Saunders SJ, Louw JH: Prolonged palliation in carcinoma of the main hepatic duct junction.Surgery 71:720–731, 1972Google Scholar
  8. 8.
    Terblanche J, Louw JH: U-tube drainage in the palliative therapy of carcinoma of the main hepatic duct junction.Surg Clin North Am 53:1245–1256, 1973Google Scholar
  9. 9.
    Hartenbach W: Experience with a biliary tract endoprothesis (in German).Chirurg 48:549–552, 1977Google Scholar
  10. 10.
    Niloff PH: A prothesis for palliative treatment of obstructive jaundice due to cholangiocarcinoma.Surg Gynecol Obstet 135:611–612, 1972Google Scholar
  11. 11.
    Burcharth F, Nielbo N: Percutaneous transhepatic cholangiography with selective catheterization of the common bile duct.Am J Roentgenol Radium Ther Nucl Med 127:409–412, 1976Google Scholar
  12. 12.
    Burcharth F, Christiansen L, Efsen F, Nielbo N, Stage P: Percutaneous transhepatic cholangiography in diagnostic evaluation of 160 jaundiced patients.Am J Surg 133:559–561, 1977Google Scholar
  13. 13.
    Molnar W, Stockum AE: Relief of obstructive jaundice through percutaneous transhepatic catheter — a new therapeutic method.Am J Roentgenol Radium Ther Nucl Med 122:356–367, 1974Google Scholar
  14. 14.
    Smith R, Sherlock S: Surgery of the gallbladder and bile ducts. pp 221–237. London: Butterworths 1964Google Scholar
  15. 15.
    Maki T, Sato T, Kakizaki G: Pancreatoduodenectomy for periamullary carcinomas.Arch Surg 92:825–833, 1966Google Scholar
  16. 16.
    Lang EK: Percutaneous transhepatic cholangiography.Radiology 112:283–290, 1974Google Scholar
  17. 17.
    Leger L, Zara et Arvay M: Cholangiographie et drainage biliaire par ponction trans-hépatique.La Presse med 42:936–937, 1952Google Scholar
  18. 18.
    Marions O, Wiechel KL: Radiological investigation in jaundice (in Swedish).Läkartidningen 70:951–956, 1973Google Scholar
  19. 19.
    Marions O, Wiechel KL: Radiological investigation in jaundice (in Swedish).Opuscula Medica suppl XXXII, 1974Google Scholar
  20. 20.
    Mujahed Z, Evans JA: Percutaneous transhepatic cholangiography.Radiol Clin North Am IV: 535–545, 1966Google Scholar
  21. 21.
    Tylén U, Hoevels J, Vang J: Percutaneous transhepatic cholangiography with external drainage of obstructive biliary lesions.Surg Gynecol Obstet 144:13–18, 1977Google Scholar
  22. 22.
    Bötticher R, Gauger U: Hepaticojejunostomy in high biliary strictures according to the method of Rodney Smith (in German).Chirurg 48:444–447, 1977Google Scholar
  23. 23.
    Ehlert CP, Schmidt HD: Iatrogenic injuries of the human bile duct (in German).Z Gastroenterol 15:119–125, 1977Google Scholar
  24. 24.
    Rosenman LD, Redman HC, Spergel L: Intubation of a biliary enteric anastomosis by percutaneous transhepatic insertion.Surg Gynecol Obstet 144:581–583, 1977Google Scholar
  25. 25.
    Saypol GM, Kurian G: A technique of repair of stricture of the bile duct.Surg Gynecol Obstet 128:1071–1076, 1969Google Scholar
  26. 26.
    Smith R: Hepaticojejunostomy: choledochojejunostomy. A method of intrajejunal anastomosis.Br J Surg 51:183–194, 1964Google Scholar
  27. 27.
    Brooks JR, Calebras JM: Cancer of the pancreas. Palliative operation, Whipple procedure or total pancreatectomy?Am J Surg 131:516–520, 1976Google Scholar
  28. 28.
    Ihse I, Lilja P, Arnesjö B, Bengmark S: Total pancreatectomy for cancer-an appraisal of 65 cases.Ann Surg 186:675–679, 1977Google Scholar
  29. 29.
    Warren KW, Cattell RB, Blackburn JP, Nora PF: A long-term appraisal of pancreaticoduodenal resection for periampullary carcinoma.Ann Surg 155:653–662, 1962Google Scholar
  30. 30.
    Mongé JJ, Judd ES, Gage RP: Radical pancreatoduodenectomy: A 22-year experience with the complications, mortality rate and survival rate.Ann Surg 160:711–719, 1964Google Scholar
  31. 31.
    Ross DE: Cancer of the pancreas.Am J Gastroenterol 31:517–524, 1959Google Scholar
  32. 32.
    Hess W: Diseases of the Biliary Tract and the Pancreas (in German). p. 505, Stuttgart: Thieme Verlag 1961Google Scholar
  33. 33.
    Burcharth F: A new endoprothesis for non-operative intubation of the biliary tract in malignant obstructive jaundice.Surg Gynecol Obstet (in press)Google Scholar
  34. 34.
    Kurachi M, Nagakawa T, Miyazaki I: Endoscopic biliary drainage. Abstract. XXVIIth Congress, Societé internationale de Chirurgie, Kyoto, Japan, 1977Google Scholar
  35. 35.
    Weber AP, Schwarz H: The indications of percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde pancreaticocholangiography (ERPC) (in German).Helv Chir acta 41:619–623, 1974Google Scholar

Copyright information

© Springer-Verlag New York Inc 1978

Authors and Affiliations

  • J. Hoevels
    • 1
  • A. Lunderquist
    • 1
  • I. Ihse
    • 2
  1. 1.Department of Diagnostic RadiologyUniversity HospitalLundSweden
  2. 2.Department of SurgeryUniversity HospitalLundSweden

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