Percutaneous transhepatic biliary drainage is used to achieve biliary decompression in jaundiced patients with biliary obstruction. High drain output >2000 mL/day is rare, and can cause dehydration and electrolyte derangements, without effective treatments. We present the first patient, to our knowledge, who reacted to the use of the analgesic ketorolac with progressive reduction in biliary output, in the setting of malignant biliary obstruction from duodenal adenocarcinoma.