Abstract:

Objective

The purpose of this study was to investigate the strategy of puncture approach in the ultrasound-guided percutaneous transhepatic biliary drainage（PTBD）producer.

Methods

We retrospectively analyzed the clinical data of 225 cases with obstructive jaundice treated with PTBD before and after the producers including the left side approach in 198 cases，the right side approach in 19 cases and the both side approach in 8 cases.

Results

The producers were successfully performed in the all patients with the guidance of the ultrasound.During the follow-up，there was no tube prolapse in the cases accepting left side approach，however，in the 12 cases with outside drainage by the right side approach，tube dislocation or shift occurred in 7 cases.The pain of the puncture site in the patients with left side approach gradually disappeared in 1 to 3 days，but the patients with right side approach suffered pain within longer time，and some patients had somewhat breathing amplitude limit which released in 3 to 7 days and lasted until 2 to 8 weeks in a few patients.

Conclusion

Ultrasound guided PTBD can be safely performed in both side approach.We recommend that the left side approach should be considered firstly in the PTBD producer because of less complications and higher quality of life.

Key words: Percutaneous transhepatic biliary drainage, Obstructive jaundice, Ultrasound-guided