Most patients with obstructive jaundice caused by primary pancreaticobiliary malignancies and metastatic disease cannot be cured by surgical resection when diagnosed. Biliary drainage in the management of obstructive jaundice therefore represents one of the most important issues in the palliative treatment of these patients. For more than 20 years, percutaneous transhepatic biliary drainage procedures have allowed a nonsurgical approach to the management of malignant biliary obstruction. Improvements in radiologic access systems have extended the use of the percutaneous biliary approach, especially since the advent of metallic stents. Nursing care of these patients before, during, and after the percutaneous biliary intervention is challenging. Patient and family need to be educated about the aim and consequences of the procedure as well as its complications. To care for these patients, the nurse must understand the techniques of percutaneous transhepatic biliary drainage. The purpose of this article is briefly to review the etiology of biliary obstruction, the current treatments to relieve obstructive jaundice, and the basic steps of biliary intervention techniques. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedural nursing care are discussed.
Nazan Tuna Oran is Staff Nurse at the Radiology Department Ege University Hospital. Izmir, Turkey, and lecturer at Ataturk Health Science School, Ege University, Izmir, Turkey.
Ismail Oran is XXX at Consultant Radiologist at the Radiology Department, Ege University Hospital, Izmir, Turkey.
Ahmet Memis is Associate Professor of Radiology at the Radiology Department, Ege University Hospital, Izmir, Turkey.
Address correspondence and reprint requests to Nazan Tuna Oran, Ege University Hospital, Department of Radiology, TR-35100 Bornova Izmir, Turkey.
Accepted for publication October 11, 1999.