Abstract
The left-lobe subxiphoid approach has been the standard way to drain left hepatic duct occlusion. A new, right-side biliary drainage approach is described.
Five patients, among 25 patients with bilateral biliary obstruction, were treated by an internalinternal drainage system. Three types of internalinternal drainage techniques are described: internal-internal luminal, type 1; internal-internal luminal, type 2; and internal-internal transductal, type 3.
All 5 patients succeeded in biliary drainage. The internal-internal biliary drainage technique, performed from the right-side approach, is effective, avoids additional liver puncture and tract dilatation, and allows the combination of several biliary drainage techniques, adding greatly to the flexibility when treating intrahepatic obstruction. No complications were observed in our small series but special precaution should be taken with the transductal technique due to the possibility of bleeding.
Similar content being viewed by others
References
Mueller PR, Ferrucci JT, van Sonnenberg E et al.: Obstruction of the left hepatic duct: diagnosis and treatment by selective fine-needle cholangiography and percutaneous biliary drainage.Radiology 145:297–302, 1982
Jaques PF, Mandell VS, Delany DJ, Nath PH: Percutaneous transhepatic biliary drainage: advantages of the leftlobe subxiphoid approach.Radiology 145:534–536, 1982
Castaneda-Zuniga WR, Tadavarthy SM, Laerum F, Amplatz D: Anterior approach for biliary duct drainage.Radiology 139:746–747, 1982
Moore PT, Clark RA: An update of interventional biliary radiology.Sem US, CT, MR 5:349–366, 1984
Ferrucci JT, Adson MA, Mueller PR, Stanley RJ, Stewart ET: Advances in the radiology of jaundice: a symposium and review.AJR 141:1–20, 1983
Takada T, Hanyu F, Kobayashi S, Uchida Y: Percutaneous transhepatic cholangial drainage: direct approach under fluoroscopic control.J Surg Oncol 8:83–97, 1976
Nakayama T, Ikeda A, Okuda K: Percutaneous transhepatic drainage of the biliary tract. Technique and results in 104 cases.Gastroenterology 74:554–559, 1978
McLean GK, Ring EJ, Freiman DB: Therapeutic alternatives in the treatment of intrahepatic biliary obstruction.Radiology 145:289–295, 1982
Druy EM, Melville GE: Obstructed hepatic duct bifurcation: decompression via single percutaneous tract.AJR 143:73–76, 1984
Jonsson K, Hellekant C: Percutaneous insertion of endoprosthesis in obstructive jaundice.Radiology 139:749–750, 1981
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Uflacker, R., Mourão, G.S., Piske, R.L. et al. Percutaneous transhepatic biliary drainage: Alternatives in left hepatic duct obstruction. Gastrointest Radiol 14, 137–142 (1989). https://doi.org/10.1007/BF01889178
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01889178