Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage

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• 作者：Daniel Knap^a ; Natalia Orlecka^b ; Renata Judka^b ; Aleksandra Juza^b ; Michał Drabek^b ; Maciej Honkowicz^b ; ^{m.honkowicz@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Tomasz Kirmes^b ; Bartosz Kadłubicki^b ; Dominik Sieroń^c ; Jan Baron^a
• 关键词：Biliary drainage ; Transhepatic cholangiography ; Jaundice ; Decompressed ducts ; Biliary complications ; Biliary tract obstruction
• 刊名：Alexandria Journal of Medicine
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：52
• 期：2
• 页码：185-191
• 全文大小：1614 K

文摘

Percutaneous Transhepatic Biliary Drainage (PTBD) is a procedure indicated in patients with non-operative lesions, when endoscopic application of prosthesis is impossible due to anatomic reasons, complications or severe general condition of patient. Most often it is a palliative procedure, aiming for live-quality improvement, although not altering prognosis of basic disease.

Aim

This study presents own experience in biliary drainage with the aid of percutaneous transhepatic method and simultaneous assessment of method effectiveness and safety. The aim was to assess outcomes and complications of PTBD in a large group of patients.

Materials and method

In time period 2007–2014, 167 patients hospitalized in Radiodiagnostics and Radiology Department of Clinical Hospital, were investigated retrospectively. PTBD procedure was applied to patients with biliary tract obstruction. In total 186 procedures of percutaneous drainage were applied. Average age of patients was 63.6 years. Bilirubin, alkaline phosphatase and gamma-glutamyl transferase were measured before and after procedure. All data were analyzed statistically.

Results

In examined group percutaneous drainage was successful in 90.7% interventions. In 8.1% procedures drainage application was ineffective. The most common complication during procedure was hemobilia (3.2%) and the long term complication was drain dislocation (2.7%). The mean bilirubin levels declined from 397.06 μmol/l before drainage to 297.88 μmol/l after drainage (p < 0.05).

Conclusions

PTBD is an effective method of biliary tract decompression and it is an important alternative to endoscopic drainage. This method is indicated in patients with neoplastic obstruction of biliary tract with low expected survival rate and thus is a palliative procedure.