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Percutaneous transhepatic biliary drainage. Complications due to multiple duct obstructions
Annals of Surgery
|July 1, 1983
Summary
Percutaneous transhepatic biliary drainage (PTBD) can lead to sepsis in over a third of patients, particularly those with malignancy-induced bile stasis. Early detection and external drainage are crucial for managing sepsis risk in these patients.
Area of Science:
- Interventional Radiology
- Gastroenterology
- Infectious Disease
Background:
- Percutaneous transhepatic biliary drainage (PTBD) is a common procedure for biliary obstruction.
- Sepsis is a serious potential complication following PTBD.
Purpose of the Study:
- To investigate the incidence and causes of sepsis in patients undergoing PTBD.
- To identify risk factors and suggest preventative measures for sepsis in PTBD patients.
Main Methods:
- Retrospective review of medical histories of 53 consecutive patients scheduled for PTBD.
- Analysis of successful catheterizations, sepsis incidents, abscesses, and sepsis following catheter removal.
Main Results:
- 36.5% incidence of sepsis among 52 successfully catheterized patients.
- Sepsis often linked to enteric bacteria and bile stasis from malignancy-induced duct obstruction.
- Bacterobilia in well-drained patients did not always result in sepsis.
Conclusions:
- Vigilance for sepsis signs is critical in patients undergoing biliary drainage.
- External drainage may be preferable for patients with incomplete biliary system emptying during PTBD.