title: Percutaneous endoscopic gastrostomy/jejunostomy combined with percutaneous transhepatic biliary drainage in treating malignant biliary obstruction.
abstract: OBJECTIVE
  To investigate the safety and efficacy of percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) combined with percutaneous transhepatic biliary drainage (PTCD) in treating malignant biliary obstruction.
  
  
  METHODS
  Nine patients (6 males and 3 females, average age 71.3 ± 5.5 years) with complete obstruction of the biliary tract were treated with PEG/PEJ after PTCD. The PEG/PEJ and PTCD tubes were linked outside of the abdominal wall to direct the externally drained bile back to the jejunum through the PEG/PEJ intestinal tube. Clinical symptoms and liver function were assessed following the treatment.
  
  
  RESULTS
  The operations were successfully completed in the 9 patients within 40 min (average 35 ± 2.9 min). Clinical symptoms such as jaundice, abdominal distension, stomachache and diarrhea appeared but improved within 7 days of the operation. Serum levels of bilirubin, aspartate aminotransferase and alanine aminotransferase were reduced (p < 0.01) 4 weeks following the treatment. There were no procedural complications.
  
  
  CONCLUSIONS
  Combined PEG/PEJ and PTCD appeared to be safe and effective in the management of malignant biliary obstruction. Further, larger-scale studies will be needed to verify findings of this report.
authors.affiliation: Department of Gastroenterology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, PR China.
authors.forename: Jian-Chang
authors.initials: JC
authors.lastname: Shu
authors.forename: Qi-Hong
authors.initials: QH
authors.lastname: Yang
authors.forename: Xia
authors.initials: X
authors.lastname: Lv
authors.forename: Wen-Ru
authors.initials: WR
authors.lastname: Zhang
authors.forename: Ming-En
authors.initials: ME
authors.lastname: Li
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhang
authors.forename: Hui-Dong
authors.initials: HD
authors.lastname: Song
authors.forename: Guo-Rong
authors.initials: GR
authors.lastname: Ye
authors.forename: Le-Xin
authors.initials: LX
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D002681:China; D018281:Cholangiocarcinoma / Q000601:surgery*; D002779:Cholestasis / Q000601:surgery*; D004322:Drainage; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007582:Jejunostomy / Q000379:methods*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D001663:Bilirubin