Abstract: Objective To investigate the effect of percutaneous transhepatic cholangio drainage (PTCD) in hilar biliary obstruction patients using biliary drainage tube with added side holes.Methods A total of 36 patients with malignant hilar biliary obstruction (32 with cholangiocarcinoma and 4 with liver metastasis tumor) underwent PTCD.The biliary drainage tube with added side holes was managed to pass through the obstructed biliary ducts percutaneously.The pigtail shaped end of the tube was put in the common bile duct distal to the obstructed tumor and the side holes were situated in the hepatic duct proximal to the obstruction to achieve internal and external biliary drainage without back flow of the intestinal juice in the whole liver (Bismuth-Corlette typeⅠandⅡ) or half liver (type Ⅲ and Ⅳ) .In multiple intrahepatic bile duct obstruction, drainage tube side hole was placed in the intrahepatic bile duct connecting the puncture site, and the end of the tube was put into other obstructed intrahepatic bile duct in order to increase drainage volume.Results The obstruction drainage tube placement was successful in 31 cases, of which 27 were internal and external drainage, and 4 were single drainage in multiple intrahepatic bile duct obstruction.The success rate in technology was 86%.PTCD of hepatic lobe or segment was done for 5 patients because the guide wire failed to pass the biliary duct occlusion.Average total bilirubin (TBIL) 1 week post PTCD decreased to 135±34μmol/L, compared to the average TBIL of 189±53μmol/L before PTCD.Clinical symptoms improved in various degrees.Conclusion Application of biliary drainage tube with added side holes helps PTCD to be effective in patients with hilar biliary obstruction.