Percutaneous transhepatic cholangiography and drainage. Risks and complications

An analysis of 237 consecutive PTC/PTD procedures revealed radiographically demonstrable complications in 21 per cent (50/237 cases: bile-contrast medium leakage 24 cases, haemobilia 18 cases) and clinically registered complications in 11% (26/237 cases: bile or blood leakage with or without peritonitis in 10 cases). Two deaths occurred. When possible, a drainage catheter was inserted for decompression. This was performed on 184 occasions in 139 patients--failure rate was 5 per cent. Unsuccessful attempt to introduce a drainage catheter constituted a major complication risk occurring in 5/13 cases (38%). Signs of infection were frequent though these complications were not a major problem in this series. Various possibilities to reduce complications and infections are discussed.