Percutaneous Transhepatic Retrieval of Dysfunctional Plastic Biliary Stents

To evaluate the safety and efficacy of percutaneous transhepatic retrieval of dysfunctional plastic biliary stent (PBS).

In this retrospective, single-center study, clinical and procedural data of 36 patients who underwent percutaneous transhepatic retrieval of dysfunctional PBS between January 2015 and April 2021 were analyzed. The primary outcomes were technical success, clinical success, complications, procedure time, and radiation exposure. The secondary outcomes were biochemical indicators (total bilirubin [TB], direct bilirubin [DB], glutamic transaminase [ALT], and CA-19-9) measured before treatment and two weeks posttreatment.

Technical and clinical success were both 100%. Minor complications occurred in 4 cases (11.2%), including 3 hemobilia (Grade 1) and 1 mild cholangitis (Grade 2). The mean procedure time was 39.22 ± 9.34 minutes, with no statistical significance between benign and malignant disease groups ([40.52 ± 9.0] min vs. [38.91 ± 9.5], p = 0.68). The mean radiation exposure was 326.13 ± 206.06 mGy, with no statistical significance between benign and malignant groups ([353.64 ± 258.93] mGy vs. [319.49 ± 196.15] mGy, p > 0.75). Liver functions parameter improved significantly after 2 weeks (TB: [168.31 ± 53.07] vs. [41.70 ± 7.29] μmol/L, DB: [133.51 ± 46.42] vs. [25.39 ± 7.26] μmol/L, ALT: [94.67 ± 38.06] vs. [47.41 ± 13.69] U/L, and CA-19-9: [479.11 ± 160.14] vs. [150.72 ± 105.72] U/mL) (all p = 0.01).

This study suggests that percutaneous transhepatic retrieval of dysfunctional PBS appears to be a safe and effective alternative when ERCP is not feasible. However, given the retrospective single-center design, limited sample size, and short follow-up, larger multicenter studies with longer observation are needed to validate these findings.