Percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts: technical considerations and complications.
Bile ducts
Biliary tract neoplasms
Cholangiography
Cholestasis
Percutaneous transhepatic biliary drainage
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
24
07
2020
accepted:
01
10
2020
revised:
10
09
2020
pubmed:
15
10
2020
medline:
16
4
2021
entrez:
14
10
2020
Statut:
ppublish
Résumé
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. 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 χ 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. 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. • 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.
Identifiants
pubmed: 33051733
doi: 10.1007/s00330-020-07368-6
pii: 10.1007/s00330-020-07368-6
pmc: PMC8043937
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3035-3041Références
Baker T, Aaron J, Borge M, Pierce K, Shoup M, Aranha G (2008) Role of interventional radiology in the management of complications after pancreaticoduodenectomy. Am J Surg 195:386–390
doi: 10.1016/j.amjsurg.2007.12.026
Cozzi G, Severini A, Civelli E et al (2006) Percutaneous transhepatic biliary drainage in the management of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts. Cardiovasc Intervent Radiol 29:380–388
doi: 10.1007/s00270-005-0102-4
Kim J, Ko G, Sung K et al (2008) Bile leak following living donor liver transplantation: clinical efficacy of percutaneous transhepatic treatment. Liver Transpl 14:1142–1149
doi: 10.1002/lt.21501
Van Delden O, Laméris J (2008) Percutaneous drainage and stenting for palliation of malignant bile duct obstruction. Eur Radiol 18:448–456
doi: 10.1007/s00330-007-0796-6
Funaki B, Zaleski GX, Straus C et al (1999) Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts. AJR Am J Roentgenol 173:1541–1544
doi: 10.2214/ajr.173.6.10584798
Hyun L, Young Hwan K, Yong JK (2004) Percutaneous transhepatic biliary drainage through the normal duct in patients with post-operative bile leakage. J Korean Radiol Soc:427–432
Venkatanarasimha N, Damodharan K, Gogna A et al (2017) Diagnosis and management of complications from percutaneous biliary tract interventions. Radiographics. 37:665–680
doi: 10.1148/rg.2017160159
Carrasco C, Zornoza J, Bechtel W (1984) Malignant biliary obstruction: complications of percutaneous biliary drainage. Radiology. 152:343–346
doi: 10.1148/radiology.152.2.6739796
Yee A, Ho C (1987) Complications of percutaneous biliary drainage: benign vs malignant diseases. AJR Am J Roentgenol 148:1207–1209
doi: 10.2214/ajr.148.6.1207
Mueller P, van Sonnenberg E, Ferrucci J (1982) Percutaneous biliary drainage: technical and catheter-related problems in 200 procedures. AJR Am J Roentgenol 138:17–23
doi: 10.2214/ajr.138.1.17
Kühn J, Busemann A, Lerch M, Heidecke C, Hosten N, Puls R (2010) Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts compared with patients with dilated intrahepatic bile ducts. AJR Am J Roentgenol 195:851–857
doi: 10.2214/AJR.09.3461
Weber A, Gaa J, Rosca B et al (2009) Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol 72:412–417
doi: 10.1016/j.ejrad.2008.08.012
Filippiadis DK BC, Pellerin O, Hoffmann RT, Krajina A, Pereira PL (2017) Cirse quality assurance document and standards for classification of complications: the Cirse classification system. Cardiovasc Intervent Radiol 1141–1146
Hatzidakis A (2003) Percutaneous transhepatic biliary drainage through the normal duct in patients with post-operative bile leakage. CIRSE Cardiovascular and Interventional Radiological Society od Europe. 2003. https://www.cirse.org/wp-content/uploads/2018/11/2003_Percutaneous-Transhepatic-Cholangiography-and-Biliary-Drainage.pdf . 06.02.2020
Pedicini V, Poretti D, Mauri G et al (2010) Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results. Eur Radiol 20:1061–1068
doi: 10.1007/s00330-009-1637-6
Berquist T, May G, Johnson C, Adson M, Thistle J (1981) Percutaneous biliary decompression: internal and external drainage in 50 patients. AJR Am J Roentgenol 136:901–906
doi: 10.2214/ajr.136.5.901
Xu C, Huang XE, Wang SX, Lv PH, Sun L, Wang FA (2015) Comparison of infection between internal-external and external percutaneous transhepatic biliary drainage in treating patients with malignant obstructive jaundice. Asian Pac J Cancer Prev 16(6):2543–2546
Lee SH, Park JK, Yoon WG et al (2007) Optimal biliary drainage for inoperable Klatskin’s tumor based on Bismuth type. World J Gastroenterol 13(29):3948–3955
doi: 10.3748/wjg.v13.i29.3948
Chandrashekhara S, Gamanagatti S, Anuradha S, Sushma B (2016) Current status of percutaneous transhepatic biliary drainage in palliation of malignant obstructive jaundice: a review. Indian J Palliat Care 224:378–387
doi: 10.4103/0973-1075.191746
Funaki B (2007) Percutaneous biliary drainage. Semin Interv Radiol 24(2):268–271
doi: 10.1055/s-2007-980050
Schmitz D, Vogl T, Abdelrehim NE et al (2019) Patient radiation dose in percutaneous biliary interventions: recommendations for DRLs on the basis of a multicentre study. Eur Radiol 29(7):3390–3400
doi: 10.1007/s00330-019-06208-6
Aroua A, Rickli H et al (2007) How to set up and apply reference levels in fluoroscopy at a national level? Eur Radiol 17:1621–1633
doi: 10.1007/s00330-006-0463-3
Kloeckner R, Bersch A, dos Santos DP, Schneider J, Düber C, Pitton M (2012) Radiation exposure in nonvascular fluoroscopy-guided interventional procedures. Cardiovasc Intervent Radiol 5:613–620