Background : The causes of obstruction of the biliary tract are both benign (75-80%) and malignant (20-25%) diseases. Over the past decade, methods of percutaneous transhepatic endobiliary interventions performed under the control of X-ray television have been widely used in clinical practice. The low invasiveness of trans-hepatic interventions on the bile ducts, their high efficiency, as a method of adjuvant therapy, proved in a large number of works published recently, allowed them to acquire the status of a generally accepted method of treatment.

Methods : In the period from 2020 to 2022 24 patients with obstructive jaundice syndrome were examined and treated.The ages of patients were from 28 to 75 years, the average age was 51 years. The majority patients were with a tumor of the head of the pancreas - 13 (54.2%) and with Klatskin's tumor - 4 (16.7%); duodenal papilla tumor - 4 (16.7%), hepatocellular carcinoma - 3 (12.4%).

Results : 15 (62.5%) patients were performed simultaneously external-internal drainage, 2 (8.3%) patients - in two stages, 1 (4.15%) patient was performed only external drainage. Two-stage external-internal drainage was due to a high degree of hyperbilirubinemia (more than 120 mmol / l), the presence of purulent cholangitis and severe dilatation of the intrahepatic ducts, which would hinder the passage of the occluded segment and lead to an increase in the invasiveness of the intervention. 4 (16.7%) patients with Klatskin's tumor were underwent bilateral drainage. In the absence of contraindications, abdominal surgery was performed. Open surgical interventions were performed in 2 (8.3%) patients, including pancreatogastroduodenal resection in 1 (4.2%) patient. Endobiliary stenting was performed in 13 (30.9%) patients, of which “Y” -shaped stenting was used in 3 (23.01%) cases. It was performed using uncoated nitinol self-expanding stents. Mortality was observed in the early postoperative period (3-7 days) in 2 cases - after performing percutaneous transhepatic cholangiography - 1 (4.2%) and stenting of the bile ducts - 1 (4.2%). The causes of death were severe hepatorenal failure.

Conclusions : An integrated approach to diagnosis and treatment with the use of additional methods of diagnosis, the empowerment of minimally invasive endobiliary and laparoscopic methods of treating patients will contribute to the reduction of complications and mortality.