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Effect of percutaneous transhepatic drainage upon liver function and postoperative mortality
Surgery, Gynecology & Obstetrics
|August 1, 1982
Summary
Percutaneous transhepatic drainage (PTD) lowered bilirubin but not to normal levels. PTD did not significantly reduce postoperative mortality compared to immediate surgery, questioning its benefit for surgical patients.
Area of Science:
- Hepatology
- Gastroenterology
- Interventional Radiology
Background:
- Percutaneous transhepatic drainage (PTD) is a procedure used to decompress the biliary system.
- The efficacy of PTD in improving outcomes for patients undergoing surgery for biliary obstruction has been debated.
Purpose of the Study:
- To analyze the outcomes of PTD in patients with biliary obstruction.
- To compare the postoperative mortality of patients treated with PTD before surgery versus those undergoing immediate surgery.
Main Methods:
- Retrospective analysis of 109 patients who underwent PTD between 1968 and 1980.
- Comparison of postoperative mortality between 58 PTD patients who later had surgery and a control group of 65 patients who had immediate surgery after diagnostic cholangiography.
Main Results:
- Serum bilirubin levels decreased during PTD but remained above normal, with the most significant reduction in the first week and in patients with higher initial bilirubin.
- Bile refeeding appeared to increase hepatic bilirubin excretion, potentially due to increased bile acid excretion.
- No significant difference in postoperative mortality was observed between the PTD-then-surgery group and the immediate surgery control group.
Conclusions:
- While PTD can reduce bilirubin levels, it may not normalize them and its routine use before surgery is questionable due to complications and mortality.
- PTD may be beneficial for palliative care in patients not suitable for surgery.