The aim of percutaneous transhepatic biliary drainage IPTBD) is to decrease serum bilirubgin level and promote liver function in patient with biliary tract disease, especially obstruction by malignant disease. But some patients showed persistient high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepatic biliary drainage was performed in 341 patients of obstructive jaundice for 5 years from July, 1981 to July , 1986 at department of radiology, Seoul National University Hospital. Follow up check the serum bilibrubin level was possible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubin level after PTBD. The results were as follows : 1. The male to female ratio was 3.4 : 1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant disease were 16 cases of bile duct cardinoma, 7 cases of pancreatic cancer and 7 cases of matasta is from stomach, colon and uterine cervix. Benign diseases were 1 cases of common hepatic duct stone and 1 case of intrahepatic duct stones. 3. The most common level of obstruction was trifurcation in 17 cases. 4. The most common indication of PTBD was palliative drainage of obstruction secondary to malighant tumor in 28 cases. 5. Change of serum bilirubin level ratio (post-PTBD level/pre-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1-3 days, 4-6 cays, 1-2 week 2-3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partial drainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases of biliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of catheter including 4 cases of hemolibilia, 1 cases of multiple intrahepatic stones, pyobilia and intrahepatic Clonorchis sinensis.