Percutaneous transhepatic biliary drainage: a retrospective single-center study of 372 patients

摘要

Background Complication rates in percutaneous transhepatic biliary drainage (PTBD) are non-uniform and vary considerably. In addition, the impact of peri-procedural risk factors is under-investigated. Purpose To compare success and complication rates of PTBD in patients with and without accompanying technical risk factors. Material and Methods A single-center retrospective study was conducted from January 2004 to December 2016. Patients receiving PTBD due to biliary obstruction or biliary leakage were included. Technical risk factors (non-distended bile ducts, ascites, obesity, anasarca, non-compliance) were assessed. Complications were classified according to the Society of Interventional Radiology. Results In total, 372 patients were included (57.3 men, 42.7 women; mean age = 66 years). Overall, 466 PTBDs were performed. Of the patients, 70.1 presented with malignancy and biliary obstruction; 26.8 had benign biliary obstruction; 3.1 had biliary leakage. Technical risk factors were reported in 57 (15.3) patients. Overall technical success of initial PTBD was 98.7, primary technical success was 97.9. In patients with non-dilatated bile ducts, primary technical success was 68.2. Overall complication rate was 15.0 (8.1 major complications, 6.9 minor complications). Neither major nor minor complications were more frequent in patients with technical risk factors (P > 0.05). In left-sided PTBD, hemorrhage was more frequent (P = 0.015). Patients with malignancy were significantly more affected by drainage-related complications (P = 0.004; odds ratio = 2.03). The mortality rate was 0.5 (n = 2). Conclusion PTBD is a safe and effective method for the treatment of biliary obstruction and biliary leaks. Complication rates are low, even in procedures with risk factors.