Total Fluoroscopy Time Reduction During Ultrasound- and Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage Procedure: Importance of Adjusting the Puncture Angle

Abstract Objectives The aim of this study was to compare success, technical complexity, and complication rates of percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts. Methods In a retrospective analysis, we evaluated all consecutive PTBD performed in our department over a period of 5 years. Technical success, technical data (side, fluoroscopy time, radiation dose, amount of contrast media, use of disposable equipment), procedure-related complications and peri-interventional mortality were compared for patients with dilated vs. non-dilated bile ducts. Independent t test and χ2 test were used to evaluate the statistical significance. Results A total of 253 procedures were performed on 187 patients, of whom 101/253 had dilated bile ducts and 152/253 not. In total, 243/253 procedures were successful. PTBD was significantly more often successful in patients with dilated vs. nondilated bile ducts (150/153 vs. 93/101; p 0.02). Overall complication rate (13%) did not differ significantly between patients with dilated vs. nondilated bile ducts. Procedures in patients with normal, nondilated bile ducts were associated with a significantly higher rate of post-interventional bleeding (5/101 vs. 0/152). Mean fluoroscopy time (42:36 ± 35:39 h vs. 30:28 ± 25:10 h; p 0.002) and amount of contrast media (66 ± 40 ml vs. 52 ± 24 ml; p 0.07) or use of disposables were significantly higher in patients with nondilated ducts. A significantly lower fluoroscopy time and amount of contrast medium were used in left hepatic PTBD. Conclusion Despite the higher technical complexity, PTBD with nondilated bile ducts was associated with similar overall complication rates but higher bleeding complications compared with PTBD with dilated bile ducts. Key Points • PTBD was associated with similar overall complication rates in patients with dilated vs. nondilated bile ducts. • Although overall complication rates were low, PTBD in patients with nondilated bile ducts was associated with a higher incidence of post-interventional bleeding. • PTBD in patients with nondilated bile ducts is technically more complex.

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Hyperalimentation of jaundiced patients on percutaneous transhepatic biliary drainage

British Journal of Surgery ◽

10.1002/bjs.1800730914 ◽

1986 ◽

Vol 73 (9) ◽

pp. 716-719 ◽

Cited By ~ 55

Author(s):

D. Foschi ◽

G. Cavagna ◽

F. Callioni ◽

E. Morandi ◽

V. Rovati

Keyword(s):

Biliary Drainage ◽

Percutaneous Transhepatic Biliary Drainage ◽

Transhepatic Biliary Drainage

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ID: 3521463 COMPARISON OF OUTCOMES IN ENDOSCOPIC ULTRASOUND-GUIDED HEPATICOGASTROSTOMY VERSUS PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE FOLLOWING FAILED ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2021.03.528 ◽

2021 ◽

Vol 93 (6) ◽

pp. AB244

Author(s):

Troy Pleasant ◽

Rishi Pawa

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Ultrasound ◽

Biliary Drainage ◽

Percutaneous Transhepatic Biliary Drainage ◽

Ultrasound Guided ◽

Endoscopic Retrograde ◽

Transhepatic Biliary Drainage

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Cost effectiveness of percutaneous transhepatic biliary drainage catheters in malignant biliary obstruction: a financial analysis

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2016.12.716 ◽

2017 ◽

Vol 28 (2) ◽

pp. S54

Author(s):

V Rachakonda ◽

J Bassuner ◽

R Murthy

Keyword(s):

Cost Effectiveness ◽

Biliary Drainage ◽

Biliary Obstruction ◽

Financial Analysis ◽

Percutaneous Transhepatic Biliary Drainage ◽

Malignant Biliary Obstruction ◽

Transhepatic Biliary Drainage

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Role of Percutaneous Transhepatic Biliary Drainage in Patients With Complications After Gastrectomy

International Surgery ◽

10.9738/intsurg-d-15-00117.1 ◽

2016 ◽

Vol 101 (1-2) ◽

pp. 78-83 ◽

Cited By ~ 2

Author(s):

Ki-Han Kim ◽

Ho-Byoung Lee ◽

Sung-Heun Kim ◽

Min-Chan Kim ◽

Ghap-Joong Jung

Keyword(s):

Biliary Drainage ◽

Percutaneous Transhepatic Biliary Drainage ◽

Duodenal Stump ◽

Surgical Interventions ◽

Afferent Loop Syndrome ◽

Soft Diet ◽

Bile Drainage ◽

Duodenal Stump Leakage ◽

Transhepatic Biliary Drainage

The aim of this study was to elucidate the role of percutaneous transhepatic biliary drainage (PTBD) in patients with duodenal stump leakage (DSL) and afference loop syndrome (ALS) postgastrectomy for malignancy or benign ulcer perforation. Percutaneous transhepatic biliary drainage (PTBD) is an interventional radiologic procedure used to promote bile drainage. Duodenal stump leakage (DSL) and afferent loop syndrome (ALS) can be serious complications after gastrectomy. From January 2002 through December 2014, we retrospectively reviewed 19 patients who underwent PTBD secondary to DSL and ALS postgastrectomy. In this study, a PTBD tube was placed in the proximal duodenum near the stump or distal duodenum in order to decompress and drain bile and pancreatic fluids. Nine patients with DSL and 10 patients with ALS underwent PTBD. The mean hospital stay was 34.3 days (range, 12 to 71) in DSL group and 16.4 days (range, 6 to 48) in ALS group after PTBD. A liquid or soft diet was started within 2.6 days (range, 1 to 7) in the ALS group and within 3.4 days (range, 0 to 15) in the DSL group after PTBD. One patient with DSL had PTBD changed, and 2 patients with ALS underwent additional surgical interventions after PTBD. The PTBD procedure, during which the tube was inserted into the duodenum, was well-suited for decompression of the duodenum as well as for drainage of bile and pancreatic fluids. This procedure can be an alternative treatment for cases of DSL and ALS postgastrectomy.

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