A New Method for Palliative Biliary Drainage in Malignant Obstructive Jaundice

When advanced biliary or pancreatic malignancies preclude application of surgery or stent placement for relief of jaundice, the remaining option is percutaneous transhepatic biliary drainage (PTBD). However, it is associated with problems such as loss of biliary fluid and minerals, malabsorption of fat, and discomfort. A new surgical method for palliative biliary drainage in malignant obstructive jaundice consists of connection of PTBD catheter to a jejunostomy catheter. With this configuration, external drainage converts to internal drainage type. This is a safe method with minimal morbidities and several advantages. It will improve the patients quality of life, minimize loss of fluid and electrolytes and permit normal enterohepatic circulation.