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Matthew C Pope1, David H Ballard2, Alan L Sticker3

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The Journal of the Louisiana State Medical Society : Official Organ of the Louisiana State Medical Society
|January 29, 2019
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Summary

Fluid drainage primarily uses the proximal side hole in pigtail and biliary catheters. Distal side holes show minimal to no contribution, suggesting they may be non-functional for effective fluid removal.

Keywords:
AbscessBiliary DrainageCatheter DrainageCholangiogramSinogram

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Area of Science:

  • Radiology
  • Medical Devices
  • Interventional Procedures

Background:

  • Biliary and abdominopelvic fluid collections often require drainage using specialized catheters.
  • Pigtail and biliary catheters are commonly employed for these drainage procedures.
  • Understanding fluid dynamics within these catheters is crucial for optimizing drainage efficacy.

Purpose of the Study:

  • To investigate and characterize fluid flow patterns through the side holes of pigtail and biliary drainage catheters.
  • To determine the functional contribution of different side holes to overall catheter output.

Main Methods:

  • Retrospective analysis of sinograms and cholangiograms in 99 patients undergoing biliary/abdominopelvic fluid drainage.
  • Evaluation of contrast flow through 10.2-F pigtail (n=81) and biliary (n=18) catheters.
  • Exclusion of cases with imaging artifacts or obscured side hole visualization.

Main Results:

  • Contrast predominantly exited from the most proximal side hole in 91.9% of cases for both catheter types.
  • Limited contrast flow was observed from the second (6.1%) and third (2.0%) most proximal side holes.
  • No contrast egress was detected from distal side holes beyond the third most proximal.

Conclusions:

  • The majority of fluid drainage occurs through the proximal side hole of pigtail and biliary catheters.
  • Distal side holes contribute negligibly to total drainage, rendering the distal catheter segment potentially non-functional.
  • Findings suggest potential for catheter design modification to improve drainage efficiency.