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Canadian Journal of Gastroenterology
Volume 4, Issue 9, Pages 579-587
Endobiliary Prostheses

Percutaneous Biliary Drainage with Emphasis on Hilar Lesions

R Gray

University of Toronto, Toronto, Ontario, Canada

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The mortality rates of surgery and percutaneous transhepatic biliary drainage (PTHBD) are comparable. Long tenn studies show that delayed complications occur in the majority of cases of PTHBD and survival is not improved compared to surgery. The many recent advances in endoscopic and percutaneous drainage techniques and the recognition that the patient is best served by a noncompetitive multidisciplinary approach will ensure that virtually every patient obtains the most satisfactory drainage possible with a minimum of risk and discomfort. Endoscopic drainage should be the first therapeutic option, with radiologic assistance in the 15 to 25% where endoscopic drainage fails or is incomplete.