Adverse Events After Percutaneous Transhepatic Biliary Drainage: A 10-Year Retrospective Analysis.

Area of Science:

• Interventional Radiology
• Gastroenterology
• Hepatology

Background:

• Percutaneous transhepatic biliary drainage (PTBD) is a crucial intervention for biliary obstruction.
• Understanding adverse event (AE) profiles and risk factors is essential for optimizing PTBD procedures.

Purpose of the Study:

• To determine the adverse event (AE) rates and profiles associated with percutaneous transhepatic biliary drainage (PTBD).
• To identify risk factors for the occurrence of AEs during PTBD procedures.

Main Methods:

• A retrospective study of 2,310 PTBD interventions in 449 patients between 2010 and 2020.
• Analysis included initial drain placements, exchanges, and stent placements, with and without cholangioplasty.
• Multivariate logistic regression was used to assess demographic and procedural variables.

Main Results:

• The most common AEs were pericatheter bile leak (44.4%), catheter occlusion (14.7%), and drain dislodgement (13.8%).
• Malignant biliary obstruction (29.8%) was associated with a significantly higher AE rate than benign obstruction (17.6%).
• Intraprocedural cholangioplasty decreased AE rates (OR, 0.63), while right-sided drains increased them (OR, 1.43).

Conclusions:

• Malignant obstruction and right-sided drains are significant risk factors for PTBD-related AEs.
• Intraprocedural cholangioplasty is associated with a reduced risk of AEs.
• These findings can guide safer and more effective PTBD procedures.