The Experience on Percutaneous Biliary Drainage in Malignant Biliary Obstruction and Associated Bilomas

Objective: To handle efficacy of percutaneous biliary drainage not only in cases with malignant biliary obstructive jaundice, but associated bilomas as well. Also, it is to evaluate our series with previous series in this review. Material and Method: Review of previous series in which between January 1998 and July 2008, percutaneous biliary drainage was performed in 47 men and 29 women, 76 patients with malignant biliary obstruction. Ages were between 29 and 80 years, mean age: 55.0 years. Our patients had pain, emesis, vomiting, itching, weakness, and weight loss, while jaundice was the clinical symptom in almost all. Biliary stent was put in 5 (6.6%). Biloma was seen in 3 (4.0%). Success was evaluated by referencing direct bilirubin levels before and after drainage and clinical recovery. These bilirubin levels were statistically compared via Wilcoxon signed ranks test. Results: It was succeeded in 70 patients. Mean bilirubin was 14.2±7.4 mg/dl (3.0-36.0) before drainage and 7.1±5.5 mg/dl (0.2-20.0) after drainage. Direct bilirubin levels decreased significantly (p<0.001). The procedure was failed in 2 (2.6%). Success was in 89.5% of malignant biliary drainages and all associated bilomas. Conclusion: Percutaneous biliary drainage is not only an effective interventional radiological method in palliation therapy of malignant biliary obstruction but also associated bilomas. Drainage type should be chosen on the grounds of clinical status of each patient and depending on expertise of operator or intervention a list and should be switched among percutaneous biliary drainage technique and endoscopic biliary drainage or surgical treatment technique.