title: Internal-external percutaneous transhepatic biliary drainage for patients with malignant obstructive jaundice.
abstract: OBJECTIVE
  To evaluate the effect of internal-external percutaneous transhepatic biliary drainage (IEPTBD) for patients with malignant obstructive jaundice.
  
  
  METHODS
  During the period of January 2008 and July 2013, internal-external drainage was performed in 42 patients with malignant obstructive jaundice. During the procedure, if the guide wire could pass through the occlusion and into the duodenum, IEPTBD was performed. External drainage biliary catheter was placed if the occlusion was not crossed. Newly onset of infection, degree of bilirubin decrease and the survival time of patients were selected as parameters to evaluate the effect of IEPTBD.
  
  
  RESULTS
  Twenty newly onset of infection were recorded after procedure and new infectious rate was 47.6%. Sixteen patients with infection (3 before, 13 after drainage) were uncontrolled after procedure, 12 of them (3 before, 9 after drainage) died within 1 month. The mean TBIL levels declined from 299.53 umol/L before drainage to 257.62 umol/L after drainage, while uninfected group decline from 274.86 umol/L to 132.34 umol/Lp (P < 0.5). The median survival time for uninfected group was 107 days, and for infection group was 43 days (P < 0.05).
  
  
  CONCLUSIONS
  The IEPTBD drainage may increase the chance of biliary infection, reduce bile drainage efficiency and decrease the long-term prognosis, and the external drainage is a better choice for patients with malignant obstructive jaundice need to biliary drainage.
authors.affiliation: Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province, Clinical Hospital of Yangzhou University, Yangzhou, China E-mail : huangxinen06@aliyun.com.
authors.forename: Chuan
authors.initials: C
authors.lastname: Xu
authors.forename: Peng-Hua
authors.initials: PH
authors.lastname: Lv
authors.forename: Xin-En
authors.initials: XE
authors.lastname: Huang
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.forename: Shu-Xiang
authors.initials: SX
authors.lastname: Wang
authors.forename: Fu-An
authors.initials: FA
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology*; D002404:Catheterization / Q000009:adverse effects* / Q000379:methods; D002780:Cholestasis, Intrahepatic / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome