ROLE OF PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE (PTBD) IN HILAR BILIARY OBSTRUCTION

Background: Hilar biliary obstruction is a condition caused by malignant or benign diseases, leading to obstructive jaundice and associated complications. Percutaneous Transhepatic Biliary Drainage (PTBD) is a well-established technique for palliation and biliary decompression in cases where endoscopic approaches are not feasible. This study evaluates the role of PTBD in patien Aim: ts with hilar biliary obstruction, assessing its efcacy in reducing serum bilirubin and liver enzyme levels, alleviating symptoms like nausea and pruritus, and analyzing associated complications. A prospective study was conducted on 34 patients diagnosed with hilar biliary obstru Methods: ction who underwent PTBD between August 2022 and January 2024. Serum bilirubin, Alkaline Phosphatase (ALP), Serum Glutamic Oxaloacetic Transaminase (SGOT), and Serum Glutamic Pyruvic Transaminase (SGPT) levels were measured before and after the procedure. Clinical symptoms and post-procedural complications were also assessed. Among the 34 patients, 71% were male and 29% female, with a mean Results: age of 52.76 ± 8.14 years. The most common cause of obstruction was cholangiocarcinoma (44%), followed by carcinoma gallbladder (23%). PTBD signicantly reduced mean serum bilirubin levels from 11.6 ± 4.3 mg/dL to 3.7 ± 2.9 mg/dL (p<0.0001), ALP levels from 521.0 ± 273.8 mg/dL to 306.8 ± 201.3 mg/dL (p=0.005), SGOT from 109.2 ± 85.1 mg/dL to 50.0 ± 38.5 mg/dL (p=0.004), and SGPT from 77.8 ± 59.8 mg/dL to 34.5 ± 23.4 mg/dL (p=0.0002). Clinical improvement was observed, with nausea decreasing from 71% to 26% and pruritus from 71% to 18% post-procedure. The complication rate was low, with catheter blockage in 6%, sepsis in 3%, and dislodgement in 6% of cases. PTBD is Conclusion: an effective and safe palliative intervention for managing hilar biliary obstruction, signicantly improving biochemical markers and symptom relief. It serves as a viable alternative in patients where endoscopic drainage is not feasible, with a low rate of complications.