Olak J, Stein L A, Meakins J L
Can J Surg. 1986 Jul;29(4):243-6.
The results of palliative percutaneous transhepatic biliary drainage were assessed retrospectively in 16 cases and prospectively in 7 between 1982 and 1985. Causes of biliary obstruction were metastatic cancer (nine), pancreatic cancer (nine), cholangiocarcinoma (three) and gallbladder cancer (two). Internal drainage was established in 78.3%. In the 19 patients who died, the mean duration of drainage was 3.6 months. Early morbidity was 17.4%. Late septic morbidity occurred in 11 patients (48%) (a total of 28 episodes). Late deaths (31.2%) resulted from upper gastrointestinal hemorrhage, hepatic abscess, septic shock, subhepatic abscess and peritonitis. Percutaneous transhepatic biliary drainage is associated with substantial morbidity (67.4%) and mortality (35.5%) from infection. Palliation was modest; only eight patients spent more than half their survival time at home, and 10 patients never left hospital. Clinical trials are required to assess the risk-to-benefit ratio and role of percutaneous transhepatic biliary drainage versus surgical bypass in patients with lesions amenable to surgery, and biliary drainage versus no treatment in patients whose tumour cannot be bypassed.
1982年至1985年间，对16例患者的姑息性经皮肝穿刺胆道引流结果进行了回顾性评估，对7例患者进行了前瞻性评估。胆道梗阻的原因包括转移性癌（9例）、胰腺癌（9例）、胆管癌（3例）和胆囊癌（2例）。78.3%的患者建立了内引流。在19例死亡患者中，平均引流时间为3.6个月。早期发病率为17.4%。11例患者（48%）出现晚期脓毒症并发症（共28次发作）。晚期死亡（31.2%）原因包括上消化道出血、肝脓肿、感染性休克、肝下脓肿和腹膜炎。经皮肝穿刺胆道引流与感染导致的高发病率（67.4%）和死亡率（35.5%）相关。姑息效果一般；只有8例患者在家度过了超过一半的生存期，10例患者从未出院。需要进行临床试验，以评估经皮肝穿刺胆道引流与手术旁路在适合手术的患者中的风险效益比和作用，以及在肿瘤无法旁路的患者中胆道引流与不治疗的风险效益比和作用。
