· Percutaneous transhepatic biliary drainage (PTBD) is indicated as a preoperative or palliative procedure for patients with malignant biliary obstruction where endoscopic procedures are difficult or failed. · Drainage of bile ducts of 30% of the liver parenchyma, i.e, less than one lobe, is sufficient for relieving the symptoms of biliary obstruction [1,2]. Hence, in cases of hepatic hilar biliary obstruction, draining the bile ducts of a single lobe is adequate[3,4]. However, which lobe (right or left) to drain is a matter of debate. There...

The study included 50 patients of malignant biliary obstruction randomized into right or left sided PTBD during the period between June 2016 and May 2018. Exclusion criteria were secondary biliary confluence involvement, hepatic lobar atrophy, uncontrollable bleeding diathesis and gross ascites. · A detailed clinical history,prothrombin time/International Normalised Ratio (INR),Bilirubin level were obtained in all the patients prior to the procedure as base line evaluation. · Screening ultrasonography (USG) was done in all patients to assess the feasibility of PTBD prior to the procedure. Block...

The study group consisted of 50 patients (25 in each group): 22 (44%) females and 28 (56%) males. The average age of the patients was 51.78 ± 12.35 (28 - 83) years. Pain · The mean procedure related pain score (VAS) for the patients in the right-sided PTBD group was 55.88 ± 17 (23-86) and in the left-sided PTBD group was 60 ± 15 (30-92). There was no significant difference between the two groups with p=0.378.

Limitations: This was a pilot project with a small sample size but done at a single institution. Multiple operators with varied individual experience performed the procedures. This may have an effect on the procedure and fluoroscopy time and thus the radiation doses. · In conclusion, the technical success, procedure time, fluoroscopy time and radiation doses to the operator and the patient were not significantly different between right-sided and left-sided PTBD. Further, there was no significant difference in procedure related pain, the clinical success, and the...

1. Polydorou AA, Cairns SR, Dowsett JF, Hatfield AR, Salmon PR, Cotton PB, et al. Palliation of proximal malignant biliary obstruction by endoscopic endoprosthesis insertion. Gut. 1991 Jun;32(6):685–9. 2. De Palma GD, Galloro G, Siciliano S, Iovino P, Catanzano C. Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction: results of a prospective, randomized, and controlled study. Gastrointest Endosc. 2001 May;53(6):547–53. 3. Gamanagatti S, Singh T, Sharma R, Srivastava DN, Dash NR, Garg PK. Unilobar Versus Bilobar Biliary Drainage: Effect...