Biliary stents in management of malignant obstructive jaundice: our experience in a tertiary care hospital

Obstruction in the biliary tract is a common cause of jaundice and often requires image guided interventions as a part of pre-operative or palliative treatment. Numerous procedures including surgical,endoscopy guided and fluroscopy-US guided have been developed. Percutaneous transhepatic biliary drainage(PTBD) with or without deployment of self expanding metallic stents(SEMS) come handy in patients when surgical intervention is not feasible . Malignancy a common cause of biliary obstruction is often detected at a stage when surgical/endoscopic approach have a little role to play ,and only percutaneous approach might prove beneficial which is a palliative treatment. Percutaneous transhepatic biliary drainage(PTBD) with or without deployment of self expanding mettalic stents(SEMS) is a well-established procedure used in patients with malignant obstruction of intra- and extrahepatic bile ducts. PTBD lowers the levels of bilirubin, prevents cholangitis, thereby providing remarkable symptomatic relief and clinical improvement, improving the general condition, quality of life and increasing survival rate drastically. It also improves liver function prior to surgery or neoadjuvant chemotherapy.As endoscopy guided stenting of biliary tract is not carried out at our hospital,all the procedures were carried out using transhepatic approach using fluroscopy and ultrasound. The indications, techniques, advantages and complications of PTBD with SEMS are presented in this review.