Reduced complication rates of percutaneous transhepatic biliary drainage with ultrasound guidance

2017 ◽  
Vol 45 (7) ◽  
pp. 400-407 ◽  
Author(s):  
Andrej Wagner ◽  
Christian Mayr ◽  
Tobias Kiesslich ◽  
Frieder Berr ◽  
Paul Friesenbichler ◽  
...  
Keyword(s):  
Biliary Drainage ◽  
Ultrasound Guidance ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Complication Rates ◽  
Transhepatic Biliary Drainage

Comparison of Ultrasound and Fluoroscopically Guided Percutaneous Transhepatic Biliary Drainage

2018 ◽  
Vol 37 (1) ◽  
pp. 77-86 ◽  
Author(s):  
Simon Nennstiel ◽  
Matthias Treiber ◽  
Alexander Faber ◽  
Bernhard Haller ◽  
Stefan von Delius ◽  
...  
Keyword(s):  
Success Rate ◽  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Standard Technique ◽  
Biliary System ◽  
Complication Rates ◽  
Success Rates ◽  
Major Complications ◽  
The Right ◽  
Transhepatic Biliary Drainage

Background: Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the palliation of an endoscopically inaccessible biliary system. Since a standard technique of PTBD is not defined, we compared a fluoroscopically guided technique (F-PTBD) with an ultrasound (US-PTBD) guided approach. Patients and Methods: Procedure characteristics, success-rates and complication-rates of the different PTBD techniques were compared in patients who underwent PTBD between October 1, 2006, and ­December 31, 2014. Results: In 195 patients, 251 PTBDs (207 F-PTBDs, 44 US-PTBDs) were performed. F-PTBDs were mostly inserted from the right and US-PTBDs from the left. Patient age, gender and physical status were comparable in both techniques. There was no difference regarding overall procedure success (90%/86.4%), overall interventional complication rates (10.6%/9.1%), fluoroscopy times, intervention times or sedatives dosages. However, major complications were only encountered in F-PTBDs. There was a higher success rate for F-PTBD vs. US-PTBD from the right side (91.9 vs. 75%; p = 0.033) and a trend towards a higher success rate for US guidance from the left side (82.9 vs. 95.8%; p = 0.223). Conclusions: For drainage of the right biliary system F-PTBD seems superior over the US-PTBD technique used in this study. However, major complications can occur more frequently in F-PTBD.

scholarly journals Percutaneous transhepatic biliary drainage (PTBD) in patients with dilated vs. nondilated bile ducts: technical considerations and complications

2020 ◽  
Author(s):  
Federico Pedersoli ◽  
Anja Schröder ◽  
Markus Zimmermann ◽  
Maximilian Schulze-Hagen ◽  
Sebastian Keil ◽  
...  
Keyword(s):  
Contrast Media ◽  
Biliary Drainage ◽  
Bile Ducts ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Statistical Significance ◽  
Fluoroscopy Time ◽  
Bleeding Complications ◽  
Complication Rates ◽  
Technical Data ◽  
Transhepatic Biliary Drainage

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.

Hyperalimentation of jaundiced patients on percutaneous transhepatic biliary drainage

1986 ◽  
Vol 73 (9) ◽  
pp. 716-719 ◽  
Author(s):  
D. Foschi ◽  
G. Cavagna ◽  
F. Callioni ◽  
E. Morandi ◽  
V. Rovati
Keyword(s):  
Biliary Drainage ◽  
Percutaneous Transhepatic Biliary Drainage ◽  
Transhepatic Biliary Drainage

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

2016 ◽  
Vol 101 (1-2) ◽  
pp. 78-83 ◽  
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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