The value of preoperatively placed percutaneous biliary catheters in reconstruction of the proximal part of the biliary tract.

Between May 1982 and January 1986, 55 patients with strictures of the proximal part of the biliary tract have been reconstructed with Silastic (silicone rubber) transhepatic biliary stents after the preoperative percutaneous placement of Ring catheters into one or both of the hepatic ducts. Twenty-five patients had tumors of the proximal portion of the biliary tract, 19 had sclerosing cholangitis and the remaining 11 had benign strictures of the biliary tract. Ring catheters were placed into both the right and left hepatic ducts in 38 of the 55 patients. In the remaining 17 patients, a single Ring catheter was advanced beyond the stricture and into the duodenum in 50 of the 55 patients. The preoperative percutaneous placement of Ring catheters into the right and left hepatic ducts has proved to be a useful technical aide in the operative management of patients with lesions of the proximal part of the biliary tract. Having these catheters in place at the time of the operation helps significantly in dissecting the extrahepatic biliary tree and bifurcation and are subsequently used to place the transhepatic Silastic stents that are used in the reconstruction of the biliary tract.