Pre-operative biliary drainage in patients with obstructive jaundice. A comparison of the percutaneous transhepatic and endoscopic transpapillary routes.

Pre-operative biliary drainage may reduce the mortality and morbidity associated with surgery in the patient with obstructive jaundice. It is possible to drain the bile duct via two routes pre-operatively The transhepatic route was used in 12 patients and the papillary route in 8. Only 1 patients died in the postoperative period. Transhepatic drainage was found suitable for routine use in patients with a dilated biliary tree, in particular in those with unresponsive cholangitis. Transpapillary drainage is not suitable for routine use but has a place in short-term drainage in patients with mild jaundice and cholangitis caused by gallstones in the bile duct.