Infections associated with transhepatic biliary drainage devices

Area of Science:

• Interventional Radiology
• Gastroenterology
• Infectious Diseases

Background:

• Transhepatic biliary drainage (TBD) is crucial for managing biliary obstruction.
• Infectious complications are a significant concern with TBD devices.

Purpose of the Study:

• To analyze infectious complications associated with different TBD devices.
• To identify common pathogens and risk factors for infection.

Main Methods:

• Retrospective analysis of 38 patients with 39 TBD devices.
• Categorization of devices: pigtail catheter, Ring catheter/feeding tube, and Carey-Coons endoprosthesis.
• Review of infectious events, pathogens, and associated factors.

Main Results:

• Nineteen infectious events occurred in 38 patients.
• Infections included bacteremia, cholangitis, and intrahepatic abscesses, frequently associated with obstruction (66.7%).
• Common pathogens: Escherichia coli and Pseudomonas aeruginosa in blood; P. aeruginosa, Klebsiella pneumoniae, and Streptococcus faecalis in bile.

Conclusions:

• TBD devices are associated with significant infectious complications.
• Obstruction is a major risk factor for infection.
• Endoprostheses may be linked to delayed infections and specific patient factors.