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Percutaneous transhepatic biliary drainage: experience with 311 procedures.
R W Günther1, H Schild, M Thelen
1Abteilung für Radiologische Diagnostik der RWTH Aachen, FRG.
Cardiovascular and Interventional Radiology
|April 1, 1988
Summary
Percutaneous biliary drainage effectively manages malignant obstructive jaundice and postoperative complications. Self-retaining catheters significantly reduced complications like dislocations.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Hepatology
Background:
- Obstructive jaundice, particularly malignant, presents significant management challenges.
- Percutaneous biliary drainage (PBD) is an established interventional radiology technique.
Purpose of the Study:
- To evaluate the efficacy and safety of PBD in a large patient cohort.
- To identify indications, complications, and outcomes of PBD.
Main Methods:
- Retrospective and prospective analysis of 311 PBD procedures in 296 patients.
- Fine-needle puncture technique utilized for PBD.
Main Results:
- PBD was primarily used for postoperative decompression (59%) and palliation of malignant obstruction (35%).
- Complications included cholangitis (6.6%), sepsis (3.1%), and bile leakage (1.6%), with a low mortality rate (0.7%).
- Catheter dislocation (8.5%) was resolved by using self-retaining catheters; prospective data showed pain (55%) and cholangitis (11.8%).
Conclusions:
- PBD is a valuable procedure for complicated biliary obstruction, palliative drainage, and endobiliary interventions.
- The technique demonstrates acceptable safety and efficacy, especially with advancements like self-retaining catheters.
- PBD plays a crucial role in managing malignant obstructive jaundice and postoperative biliary complications.