Percutaneous drainage and stenting for palliation of malignant bile duct obstruction.
Percutaneous biliary drainage and stenting (PTBD) for palliation of malignant obstructive jaundice has evolved to a safe and effective technique. PTBD is equally effective for treatment of distal and proximal bile obstruction. Metal self-expandable stents have proved superior to plastic stents and should therefore be used. Technical success is >90% en clinical success is >75% in all major series. There are a considerable number of complications, but most can be treated conservatively and procedure-related mortality is <2% in most series. Thirty-day mortality after PTBD is >10% in many series, but this is largely due to the underlying disease. About 10-30% of patients will have recurrent jaundice at some point in their disease after PTBD and require re-intervention.
van Delden
Otto M
OM
Department of Radiology, Academic Medical Center of the University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. o.m.vandelden@amc.uva.nl
Laméris
Johan S
JS
D001650:Bile Duct Neoplasms / Q000150:complications*; D018281:Cholangiocarcinoma / Q000150:complications; D002779:Cholestasis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D006801:Humans; D008670:Metals; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000150:complications; D015607:Stents; D014057:Tomography, X-Ray Computed
D008670:Metals