J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1705KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 87(9): 1083-1086, 1986

Report on the annual meeting

RE-EVALUATION OF PREOPERATIVE PERCUTANEOUS TRANSHEPATIC CHOLANGIODRAINAGE FOR OBSTRUCTIVE JAUNDICE
－A SPECIAL REFERENCE TO PLASMA ENDOTOXIN－

First Surgery Department, Teikyo University School of Medicine, Tokyo, Japan
*) Gastroenterological Surgery Department, Tokyo Women’s Medical College, Tokyo, Japan

Tadahiro Takada, Junnichi Shikata, Fujio Hanyu*)

Although obstructive jaundice appeared to be overcome by the establishment of percutaneous transhepatic cholangiodrainage (PTCD), active controversies on necessity of PTCD have been recently arisen. We, therefore, reviewed our past results of PTCD and examined changes in the circulating endotoxin levels as a parameter for evaluation of the necessity of PTCD for obstructive jaundice.
1) The incidence of complications of after PTCD by X-ray guided puncture was 7.7% in 457 patients between January, 1968 and September, 1980. However, in 365 patients who received PTCD by ultrasonically guided puncture since October, 1980, it decreased to 0.8%. (2) The rate of surgical death was significantly lower in those who received surgery after PTCD (11.2%) than in those who underwent surgery without PTCD (38.7%). (3) The patients who received PTCD showed low endotoxin levels after the procedure. The patients who underwent surgery after PTCD showed the circulating endotoxin levels similar to those in the patients without jaundice. Contrary to these, the patients who underwent onestage surgical operation without PTCD showed high endotoxin changes.
These results support the preoperative PTCD in obstructive jaundice.

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