Percutaneous Transhepatic Biliary Drainage for the Treatment of Obstructive Jaundice Caused by Metastases from Nonbiliary and Nonpancreatic Cancers

The usefulness of percutaneous transhepatic biliary drainage(PTBD) in the treatment of obstructive jaundice caused by metastasesfrom nonbiliary and nonpancreatic cancers was evaluated. Eighteenpatients underwent PTBD during a 3-year period. The primarycancers were located in the stomach (nine cases), colon (four),lung (three), uterus (one), and breast (one). The causes ofobstructive jaundice and bile duct strictures were investigatedusing both abdominal computed tomography and abdominal ultrasonography.The causes of obstructive jaundice, the usefulness of PTBD interms of the relief of symptoms and laboratory data, survivalafter PTBD, and the relationship between patient characteristicsand survival were evaluated. Obstructive jaundice was most oftenattributable to metastases to the lymph nodes (17 of 18 cases).One case was attributed to metastasis to the liver. PTBD decreasedthe jaundice and relieved the symptoms caused by biliary tractobstruction. Median survival after PTBD was 59 days. Patientswhose performance status was 2 or less survived longer thanthose with a performance status of 3 or more (P = 0.018). Furthermore,patients aged less than 60 years tended to survive longer thanthose aged 60 or over (P = 0.057). Our results suggest thatPTBD is useful for relief of symptoms caused by obstructivejaundice in patients with nonbiliary and nonpancreatic cancers.