The comparative assessment of various methods of biliary decompression in obstructive jaundice caused by tumors of the pancreatobiliary zone, applied before radiation therapy

Research objective: To estimate efficiency of the urgent and final decompression of biliary system and terms of restoration of liver functional impairment in tumors of pancreatobiliary zone, complicated by obstructive jaundice. Materials and methods: 272 patients with tumors of pancreatobiliary zone complicated by obstructive jaundice were included into the research, At the first stage, percutaneus intrahepatic external, external-internal and endoscopic biliary drainage was executed as an urgent decompression of the biliary tract. Long-term external-internal biliary drainage, an endoscopic biliary stenting and creating biliary bypasses were executed as a final decompression. Main results: Restoration of a liver function in patients in a subcompensated stage of hepatic failure has been achieved in 12-16 days, and in the decompensated stage - in 20-24 days after elimination of jaundice and did nott depend on the biliary drainage method. The plan of radiation therapy was changed in 20% of patients, who underwent biliary bypass, owing to the different types of dyspepsia, increase of jaundice and anastomositis, and in 12% cases only the palliative program of radiation therapy was carried out. For the patients with long-term external-internal biliary drainage those rates were 6,9% and 4,2% respectively. Conclusion: The best method of the final decompression of biliary tract is percutaneous intrahepatic external-internal drainage, which provides carrying out the radical program of radiation therapy in earlier terms, with the minimum rate of complications and reactions.