Biliary decompression in patients with obstructive jaundice

Abstract

Background: Benign and malignant diseases of bile ducts usually cause mechanical jaundice. The aim of the study: To determine the optimal duration of percutaneous transhepatic biliary drainage (PTBD) depending on the duration of mechanical jaundice and the initial level of total bilirubin in the serum. Methods: This paper presents the experience of using PTBD in 88 patients with benign and malignant diseases of bile ducts complicated by mechanical jaundice, who were hospitalized at the State Institution “V. T. Zaitsev Institute of General and Urgent Surgery of the National Academy of Medical Sciences of Ukraine” from 2011 to 2017 years. Patients were divided into three groups. The first group consisted of 15 (17.1%) patients with benign diseases of the biliary tract. The second group consisted of 11 (12.5%) patients with resectable cholangiocarcinomas. The third group – 62 (70.4%) patients with unresectable cholangiocarcinomas. Results: For patients of group 1, the process is somewhat slower, but the end result is also quite strongly influenced by the initial level of total bilirubin. The duration of biliary decompression in this category of patients averages 10-12 days. For patients in group 2, biliary decompression requires at least 12 days, but the result is not significantly affected by the initial level of total bilirubin and the duration of obstructive jaundice. Conclusions: Using the Poisson process, or more precisely the quasi-Poisson distribution, it was possible to determine the optimal duration of biliary decompression by using PTBD depending on the duration of obstructive jaundice and the initial level of total serum bilirubin.