The significance of nonsurgical bile duct drainage in patients with icterus

Operation of the biliary pathways in patients with obstructive jaundice is still associated with a significant morbidity and high mortality, in particular in geriatric patients. Recently in the therapy of icteric patients percutaneous or endoscopic drainage of the biliary pathways was introduced. At the Surgical Clinic of the Hospital with Policlinic, Bezrucova in Bratislava in 1988 52 patients with obstructive jaundice were hospitalized. In patients with more than three risk factors the authors introduced preoperative drainage of the biliary pathways. In patients with malignant disease they describe preoperative percutaneous transhepatic drainage with subsequent enterobiliary anastomosis with an in-dwelling drain. Of 52 patients 9 died, i.e. 17.3%. Non-surgical drainage of the biliary pathways in icteric patients reduces the number of risk factors, eliminates the adverse effects of jaundice and improves the prognosis of the icteric patient.