Obstructions of the hepatic duct confluence: internal drainage of bilateral lesions with a single catheter.

Strictures at the confluence of the right and left hepatic ducts are difficult to treat surgically, endoscopically, or percutaneously. Percutaneous decompression techniques previously described involved separate transhepatic catheterizations of the isolated right and left ducts. In the present study, modifications of existing self-retaining loop drainage catheters allowed bilateral internal biliary drainage of isolated right and left hepatic ductal systems with a single catheter in three patients. The technique can be used for primary palliation and for recurrent strictures after hepaticojejunostomy.