Tecnica di anestesia locale per il trattamento ambulatoriale della patologia proctologica

Experience with a total of 362 percutaneous transhepatic biliary drainages (PTBD) carried out between January 1977 and December 1988 is described here. Of these 350 were correctly placed and 285 (81.5%) gave a good result, 53 (15.1%) a fair result and 12 (3.4%) a poor outcome. In 12 of the total number of cases (3.4%) it was not possible to position the drain effectively. Mortality of the method was 0.8% (3 cases). Complications were as follows: obstruction 7 (1.9%), dislocation 15 (4.1%), hemobilia 15 (4.1%), hemoperitoneum 1 (0.2%), cholangitis 6 (1.6%), choleperitoneum 10 (2.7%). In view of the good results and low incidence of complications the conclusion is that in skilled hands PTBD is a very useful method that should be available in any centre specializing in hepatobiliary surgery.