Hybrid intervention with angio-CT for percutaneous transhepatic biliary drainage (PTBD)
Jonathan Nadjiri1, Tobias Geith2, Tobias Waggershauser2
1Ismaninger Str 22, TUM Klinikum Munchen, TUM School of Medicine and Health, Interventionelle Radiologie, München, Germany. jonathan.nadjiri@tum.de.
Purpose:
To evaluate a hybrid angiography-CT (angio-CT) system for percutaneous transhepatic biliary drainage (PTBD) in patients with biliodigestive anastomosis, aerobilia, and the need for external biliary drainage.
Materials And Methods:
Ten patients with bile duct leakage and aerobilia underwent angio-CT-guided PTBD. The angio-CT enabled combined CT and fluoroscopic imaging in a single procedural setting. Aerobilia facilitated bile duct visualization, particularly in left-sided ducts. Key steps included CT-guided puncture, fluoroscopic catheter placement, and integration of both modalities to streamline workflow.
Results:
Successful biliary access and drainage were achieved in all cases. The combined imaging approach allowed for short intervention times (mean: 25 min) and ensured safety without complications. Aerobilia, improved visualization and precision were key contributors to the technique's success.
Conclusion:
Angio-CT may improve procedural precision and safety when aerobilia is present.The integration of CT and angiography within a single system offers a reliable solution for challenging biliary interventions. Larger studies are needed to confirm these findings.
