Percutaneous transhepatic biliary drainage: a review.

Area of Science:

• Interventional Radiology
• Hepatobiliary Surgery
• Gastroenterology

Background:

• Percutaneous transhepatic biliary drainage (PTBD) has evolved significantly over 35 years, with recent technical refinements enhancing its clinical utility.
• Initially, PTBD was primarily for palliative decompression in malignant biliary obstructions, despite known long-term complications like cholangitis.
• Its application has expanded to managing benign biliary diseases, where shorter drainage periods can mitigate complications.

Purpose of the Study:

• To review the technique and complications of PTBD.
• To explore the evolving applications of PTBD in both malignant and benign biliary diseases.
• To highlight the potential of PTBD in therapeutic interventions for biliary conditions.

Main Methods:

• Review of the technique for percutaneous transhepatic biliary drainage.
• Analysis of complications associated with PTBD, including cholangitis and catheter-related issues.
• Examination of PTBD's role in managing malignant and benign biliary obstructions and diseases.

Main Results:

• PTBD remains a viable option for advanced malignancies when few alternatives exist.
• PTBD is increasingly utilized for benign biliary diseases, often requiring only short-term drainage.
• The transhepatic tract facilitates therapeutic manipulations such as lithotripsy, stricture dilatation, and sphincterotomy.

Conclusions:

• PTBD is a valuable tool in managing both malignant and benign biliary diseases.
• Ongoing advancements in transhepatic instruments and techniques are expected to further enhance PTBD's impact.
• PTBD offers a minimally invasive approach with expanding therapeutic capabilities in hepatobiliary interventions.