Technical Considerations and Complication of Percutaneous Transhepatic Biliary Drainage: A Single Center Retrospective Study

Abstract

Introduction: With comparable outcomes, percutaneous transhepatic biliary drainage (PTBD) is the preferred method for relieving biliary obstruction when the gold standard endoscopic retrograde cholangiopancreaticography (ERCP) fails or is not practicable.

Aims & Objectives: To evaluate the technical success rate, clinical success rate, and complications of PTBD.

Place and duration of study: This study was carried out in Radiology Department of Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan from 29^th February 2020 to 1^st November 2021.

Material & Methods: In this study, consecutive PTBD procedures performed from 29^th February 2020 to 1^st November 2021 were retrospectively reviewed. We collected data including patients' age, gender, diagnosis, indications, prior ERCP performance, preoperative and post operative bilirubin, and complications. Technical success, clinical success, and complications were documented. SPSS Version 26 was used for data entry and analysis, P-value<0.05 was taken as significant.

Results: A total of 96 procedures were performed in 64 patients with the mean age of 52 years (range: 20 - 91 years). Out of 96, 66 (68.8%) procedures were performed in malignant obstruction with most common cause being cholangiocarcinoma (24%). Technical success was achieved in100% of the cases while clinical success rate was 90.6%. In total 96 procedures, 7 complications were reported. Major complication rate was 5.2%. These included 2 cases of post-procedure cholangitis (2.1%), 2 cases of acute pancreatitis (2.1%), and a case of bilio-venous fistula (1%). Minor complication rate (including 2 cases of pericatheter leakage) was 2.1%.

Conclusion: PTBD is a reliable and effective procedure. In general, complication rate after PTBD is not high, and the patients having malignant disease were more prone to the complications.