Persistent high serum bilirubin level after percutaneous transhepatic biliary drainage: analysis of 32 cases
10.3348/jkrs.1986.22.6.1027
- Author:
In Wook CHOO
;
Byung Ihn CHOI
;
Jae Hyung PARK
;
Man Chung HAN
;
Chu Wan KIM
- Publication Type:Original Article
- MeSH:
Bile;
Bile Ducts;
Biliary Tract Diseases;
Bilirubin;
Cervix Uteri;
Clonorchis sinensis;
Drainage;
Female;
Fibrosis;
Follow-Up Studies;
Hepatic Duct, Common;
Humans;
Jaundice, Obstructive;
Liver Abscess;
Male;
Pancreatic Neoplasms;
Seoul;
Stomach
- From:Journal of the Korean Radiological Society
1986;22(6):1027-1033
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The aim of percutaneous transhepatic biliary drainage(PTBD) is to decrease serum bilirubin level and promoteliver function in patient with biliary tract disease, especially obstruction by malignant disese. But somepatients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepaticbiliary drainage was performed in 341 patients of obstructive jaundice for 5 years from July, 1981 to July, 1986at departement of radiology, Seoul Natinal University Hospital. Follow up check of the serum bilibrubin level waspossible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubinlevel after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant diseasewere 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of matastasis from stomach, colonand uterine cervix. Benign disease were 1 cases of common hepatic duct stone and 1 case of intrahepatic ductstones. 3. The msot common level of obstruction was trifurcation in 17 cases. 4. The most common indication ofPTBD was palliative drainage of obstruciton secondary to malignant tumor in 28 cases. 5. Change of serujmbilirubin level ratio(post-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1–3 days, 4–6 days, 1–2 week 2–3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partialdrainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases ofbiliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of cather including 4 cases ofhemobilia, 1 case of multiple intrahepatic stones, pyobilia and intraheptic Clonorchis sinensis.
