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[The current value of percutaneous transhepatic biliary drainage]
K Oberholzer1, M B Pitton, P Mildenberger
1Klinik für Radiologie, Universitätskliniken der Johannes-Gutenberg-Universität Mainz. oberholz@radiologie.klinik.uni-mainz.de
Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|September 11, 2002
Summary
Percutaneous transhepatic biliary drainage (PTBD) is a valuable treatment for obstructive jaundice, primarily for palliative care. While preoperative PTBD
Area of Science:
- Interventional Radiology
- Gastroenterology
- Hepatology
Background:
- Obstructive jaundice, often due to malignant diseases, requires effective management.
- Percutaneous transhepatic biliary drainage (PTBD) is an established interventional radiology procedure.
- The role of preoperative PTBD in improving surgical outcomes has been debated.
Purpose of the Study:
- To evaluate the changing indications and outcomes of PTBD over a 16-year period.
- To assess the safety and efficacy of PTBD, particularly in complex cases.
- To compare PTBD outcomes with endoscopic biliary drainage.
Main Methods:
- Retrospective analysis of over 1000 PTBD procedures.
- Review of patient data spanning two distinct nine- and seven-year periods.
- Documentation of indications, complications, and outcomes.
Main Results:
- Indications for preoperative PTBD decreased significantly, with palliative procedures comprising nearly 70% of all treatments.
- Overall serious complication rates were low (5% and 3.4% in the two periods).
- Specific complication rates (sepsis, peritonitis, bleeding, procedure-related death) were comparable to or lower than endoscopic approaches.
Conclusions:
- PTBD remains a safe and effective treatment for obstructive jaundice, especially when endoscopic methods fail or are not feasible.
- The primary role of PTBD has shifted towards palliative care.
- PTBD offers comparable safety and efficacy to endoscopic drainage, with low complication rates.