Percutaneous drainage and stenting for palliation of malignant bile duct obstruction

Percutaneous biliary drainage and stenting (PTBD) for palliation of malignant obstructive jaundice has evolved to a safe and effective technique. PTBD is equally effective for treatment of distal and proximal bile obstruction. Metal self-expandable stents have proved superior to plastic stents and should therefore be used. Technical success is > 90% en clinical success is > 75% in all major series. There are a considerable number of complications, but most can be treated conservatively and procedure-related mortality is < 2% in most series. Thirty-day mortality after PTBD is > 10% in many series, but this is largely due to the underlying disease. About 10-30% of patients will have recurrent jaundice at some point in their disease after PTBD and require re-intervention.