Radiological management of obstructive jaundice.

Percutaneous transhepatic biliary drainage (PTHBD) is a new interventional radiologic procedure that can be applied in the management of malignant or benign biliary obstruction. PTHBD can be (1) retrograde, whereby bile is drained externally through a catheter and collected in a bag; (2) antegrade, whereby the obstructing lesion, usually a carcinoma of the pancreas, is bypassed with a catheter and bile is drained internally into the duodenum; or (3) a combination of both. PTHBD may be a definitive palliative procedure or a preoperative biliary decompressive modality when subsequent surgery or radiation therapy is planned. The experience at Howard University Hospital with this modality is reviewed; its indications, contraindications, and complications are discussed; and a limited review of the literature is offered. With the increasing incidence of pancreatic carcinoma in our patient population, PTHBD is bound to play an increasing role.