To investigate the interventional draining method and clinical therapeutic effect in proximal complicated multibranch biliary obstruction caused by hilar cholangiocarcinoma.

A total of 38 patients with hilar cholangiocarcinoma were enrolled, including 28 males and 10 females. Among them, there were 6 cases of Bismuth-Corlett II, 18 cases of type III, and 14 cases of type IV. Based on the obstructive position, extent, and dilated degree of the biliary tract, individual designs were made for the drainage scheme in the different cases. In 30 cases, the simple drainage tubes were adopted and the drainage tubes were improved by cutting lateral aperture, 1-3 pieces of the tube were inserted for individual patient. In 8 cases, double biliary stents were implanted and different implanting methods were adopted according to the branch angles of left and right hepatic ducts.

The interventional draining operations were successfully completed in all cases and no severe complication happened except for slight hemobilia in 2 patients. The jaundice of all the patients was alleviated or disappeared obviously after the operations, itch of skin and the symptom of cholangitis dribbled away. The serum total bilirubin level was lowered from preoperative (242.69±27) μmol/L to (58.32±5.6) μmol/L after 1-2 weeks of the operation (t=9.73, P<0.05) . Stent restenosis happened and jaundice relapsed in 3 cases after 4-6 months of stent implantations, respectively, and biliary external drainages were made once again.

It is demonstrated that the improved method of cutting lateral aperture on the drainage tube is convenient with reduced trauma and satisfactory curative effect, a single drainage tube can be used to drain the obstructive bile of more biliary branches, or the general external drainage tube can produce the effect of exterior and interior drainage tube. According to the hepatic ducts branch angle, adopting different stent inserting methods is practicable.