Percutaneous transhepatic biliary drainage: a retrospective single-center study of 372 patients. (April 2023)

• Record Type: Journal Article
• Authors: Handke, Nikolaus A; Ollig, Annika; Attenberger, Ulrike I; Luetkens, Julian A; Faron, Anton; Pieper, Claus C; Schmeel, Frederic C; Kupczyk, Patrick A; Meyer, Carsten; Kuetting, Daniel
• Is Part Of: Acta radiologica. Volume 64:Number 4(2023)
• Page Start: 1322
• Page End: 1330
• Publication Date: 2023-04
• Subjects: Percutaneous transhepatic biliary drainage -- risk factors -- technical success -- complications; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/02841851221127809
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Complication rates in percutaneous transhepatic biliary drainage (PTBD) are non-uniform and vary considerably. In addition, the impact of peri-procedural risk factors is under-investigated. Purpose: To compare success and complication rates of PTBD in patients with and without accompanying technical risk factors. Material and Methods: A single-center retrospective study was conducted from January 2004 to December 2016. Patients receiving PTBD due to biliary obstruction or biliary leakage were included. Technical risk factors (non-distended bile ducts, ascites, obesity, anasarca, non-compliance) were assessed. Complications were classified according to the Society of Interventional Radiology. Results: In total, 372 patients were included (57.3% men, 42.7% women; mean age = 66 years). Overall, 466 PTBDs were performed. Of the patients, 70.1% presented with malignancy and biliary obstruction; 26.8% had benign biliary obstruction; 3.1% had biliary leakage. Technical risk factors were reported in 57 (15.3%) patients. Overall technical success of initial PTBD was 98.7%, primary technical success was 97.9%. In patients with non-dilatated bile ducts, primary technical success was 68.2%. Overall complication rate was 15.0% (8.1% major complications, 6.9% minor complications). Neither major nor minor complications were more frequent in patients with technical risk factors ( P > 0.05). In left-sided PTBD, hemorrhage was more frequent ( P = 0.015). Patients with malignancy were significantly more affected by drainage-related complications ( P = 0.004; odds ratio = 2.03). The mortality rate was 0.5% (n = 2). Conclusion: PTBD is a safe and effective method for the treatment of biliary obstruction and biliary leaks. Complication rates are low, even in procedures with risk factors.