Palliative bile duct decompression with various modifications are currently performed in 75-80% of patients with hilar stenosis caused by the tumor. The main goal of palliative care is to reduce the manifestations of jaundice, intoxication, pain syndrome, prolong life period and improve patient's conditions for chemotherapy.Objective: to evaluate the effectiveness of bile ducts antegrade drainage methods by bilirubin reducing in the palliative treatment of patients with jaundice due to hilar stenosis caused by the tumor. Materials and methods.In a prospective study included 78 patients with hilar obstructive jaundice, who were underwent of palliative antegrade draining of bile ducts: percutaneous transhepatic cholangiostomy (group PTC) -n = 24, externally-internal suprapapillary cholangiostomy (group EISC) -n = 26, percutaneous transhepatic antegrade endobiliary stenting (group PTAES) -n = 28. Endpoints of the study: total serum bilirubin before the procedure, after 3, 7 days and every 10 days for two months. The mean values of bilirubin and the average percentage of decrease in its value at each of the control periods were evaluated in relation to the initial level. Also, at the same time, the cumulative percentage of patients in which bilirubin had a value of ≤34.2 μmol / L (2 mg / dL) or ≤ 85.5

Objective. To compare the efficacy of methods of miniinvasive palliative treatment of malignant hilar strictures with the jaundice syndrome. Materials and methods. Into the investigation 71 patients, suffering proximal obturation jaundice of tumoral genesis, were included. The patients were divided into three Groups: Group I - 26 patients, to whom external-internal suprapapillary cholangiostomy was done; Group II - 28 patients, in whom transcutaneous transhepatic antegrade endobiliary stenting was performed; Group III -17 patients, to whom endoscopic retrograde biliary stenting was accomplished. Results. Technical success in all the Groups have constituted 100%; clinical one - in 94.0%: in Group I - 96.2%, in Group II - 89.3%, and in group III - 82.4% (p>0.05). In Group I general rate of morbidity was lesser, including cholangitis and pancreatitis. The duration of cholangitis was lesser as well. Cumulative survival were the highest in Group of patients, to whom external-internal suprapapillary cholangiostomy was performed (135 days at average), while the least one - in Group of the patients, in whom endoscopic retrograde biliary stenting was done (90,6 days). In Group of patients, to whom transcutaneous transhepatic antegrade endobiliary stenting was performed, this index have constitited 101.2 days. Conclusion. In proximal strictures of biliary ducts of tumoral genesis on background of jaundice the priority method of palliative treatment must be external-internal suprapapillary cholangiostomy, while the second-line of surgical treatment must constitute transcutaneous transhepatic antegrade endobiliary stenting. Endoscopic retrograde biliary stenting owes the lowest priority.