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Procedure-related risk factors for bleeding after percutaneous transhepatic biliary drainage: A systematic review and

Yao-Ting Lee1, Kuang-Chen Yen1, Po-Chin Liang2

  • 1Departments of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|December 14, 2021
PubMed

Insights

Bleeding after percutaneous transhepatic biliary drainage (PTBD) is a serious concern. A left-sided approach increases the risk of hepatic arterial injuries during PTBD procedures.

Area of Science:

  • Interventional Radiology
  • Hepatobiliary Surgery
  • Gastroenterology

Background:

  • Bleeding is a significant complication of percutaneous transhepatic biliary drainage (PTBD).
  • Identifying procedure-related risk factors for PTBD bleeding is crucial for improving patient outcomes.
  • Existing data on these risk factors remain controversial.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature.
  • To identify specific procedure-related risk factors associated with bleeding after PTBD.

Main Methods:

  • Searched PubMed, Cochrane, and Google Scholar databases up to May 1, 2021.
  • Included studies with bleeding complications and comparative data on procedure-related factors.
  • Assessed bias using Newcastle-Ottawa Scale and Cochrane risk-of-bias tool.

Main Results:

  • Eleven studies were included in the meta-analysis.
  • No significant difference in bleeding rates was found based on PTBD side, insertion level, or ultrasound guidance.
  • A left-sided approach was associated with a higher risk of hepatic arterial injuries (OR=1.93, 95% CI: 1.32-2.83).

Conclusions:

  • The left-sided approach is identified as a risk factor for hepatic arterial injuries following PTBD.
  • Further research may focus on mitigating risks associated with left-sided PTBD approaches.
Abstract

Keywords:
FluoroscopyHemobiliaInterventionalJaundiceObstructiveRadiographyUltrasonography

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