Changes of Bile Contents and Reduction of Jaundice by Percutaneous Transhepatic Cholangial Drainage in Obstructive Jaundice.

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  • OZAWA KUNIO
    Department of Surgery, Juntendo University School of Medicine

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  • 閉塞性黄疸に対する経皮的胆管ドレナージ (PTCD) 後の黄疸軽減効果と胆汁組成の関連について
  • ヘイソクセイ オウダン ニ タイスル ケイヒテキ タンカン ドレナージ PTC

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The percutaneous transhepatic cholangial drainage (PTCD) is much beneficial method for reduction of jaundice than the conventioval surgical bile drainage method in obstructive jaundice cases to patients, with easier procedure and less complications. In this paper, the factors of effectiveness of this method is discussed. Thirty nine cases of complete obstructive jaundice cases were examined and analysed the reduction effect, according to the time change of bile contents, liver function, strategical portion of obstruction, and liver biopsy. Liver function before and after PTCD showed no significant difference in cases of responded and non-responded. The portion of obstruction was lower, the response to PTCD was better. Discharges of over 300m1/day of bile, over 150mg/day of cholesterol, over 150mg/day of birilubin, and or 150mg/day of bile acid were indication for reduction effect of jaundice. Especially the amonut of birilubin in drainaged bile reflected the effectiveness. Electrolytes in bile, and alkaline phsphatase did not show significant changes. In cases performed surgical drainage, the amount of bile and bile acid drained for first and second week was relatively small, which was thought to be the effect of anesthesia and surgery. The histopathology of biopsy material showed no significant difference.

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