Radiology, Vol 152, 353-356, Copyright © 1984 by Radiological Society of North America
Routine preoperative biliary drainage: effect on management of obstructive jaundice
RP Gobien, JH Stanley, CD Soucek, MC Anderson, I Vujic and BS Gobien
The routine application of preoperative percutaneous transhepatic biliary
drainage (PTBD) to patients who have obstructive jaundice has a significant
effect on overall morbidity, mortality, and patient survival by allowing
selective application of the most appropriate therapeutic modality.
Surgical patients who undergo PTBD were compared with those for whom PTBD
was not available. The surgical complication rate was 44% for those who did
not undergo PTBD and 15% for those who did. The surgical procedure-related
mortality rate was 30% for those who did not undergo PTBD and 12% for those
who did. These differentials may have been due either to a beneficial
effect of presurgical decompression or to the fact that only more favorable
candidates were selected for operative internal bypass. There was an
overall increase in length of survival following the application of PTBD,
especially in those patients who were surgical candidates.
