Objective: To investigate the safety and efficacy of percutaneous endoscopic gastrostomy/jejunostomy (PEG/PEJ) combined with percutaneous transhepatic biliary drainage (PTCD) in treating malignant biliary obstruction. Subjects and Methods: Nine patients (6 males, average age 71.3±5.5 years) with complete obstruction of biliary tract were treated with PEG/PEJ after PTCD. The PEG/PEJ and PTCD tubes were linked outside of abdominal wall to direct the externally drained bile back to jejunum through the PEG/PEJ intestinal tube. Clinical symptoms and liver function were assessed following the treatment. Results: The operations were successfully completed in the 9 patients within in 40 min (average 35±2.9 min). Clinical symptoms, such as jaundice, abdominal distension, stomachache and diarrhea appear to be alleviated within 7 days of the operation. Serum levels of bilirubin, AST and ALT were reduced (P<0.01) 4 weeks following the treatment. There were no procedural complications. Concussions: Combined PEG/PEJ and PTCD appears to be safe and effective in the management of malignant biliary obstruction. Further, larger scale studies will be needed to verify findings of this report.
Shu, J., Yang, Q-H., Lv, X., Zhang, W-R., Li, M-E., Zhang, X-Y., Song, H-D., Ye, G-R., & Wang, L. (2010). Percutaneous endoscopic gastrostomy/jejunostomy combined with percutaneous transhepatic biliary drainage in treating malignant biliary obstruction. Medical Principles and Practice, 20(1), 47-50. https://doi.org/10.1159/000322073