Type:
Educational Exhibit
Keywords:
Obstruction / Occlusion, Multidisciplinary cancer care, Puncture, Complications, Percutaneous, Fluoroscopy, CT, Liver, Interventional non-vascular, Biliary Tract / Gallbladder
Authors:
A. BHARADWAZ; AARHUS, Re/DK
DOI:
10.1594/ecr2013/C-0744
Conclusion
Complications of percutaneous biliary interventions varies with patient status,
diagnosis and degree of biliary dilatation [5] with low complication rates,
both major and minor,
with the use of a 21G needle [6].
In this series all fatalities directly attributable to major vascular complications occurred after cannulation by a thin needle (21G) in non-dilated/ mildly dilated biliary tract and/or repeated or vigorous manipulation with equipment/catheters.
Patient status however had an impact on choice of therapy after development of complications.
Overall rate of major complications in this series was 10.8% which is well in tune with the recommended threshold (10%) of SIR (Society of Interventional Radiology) quality improvement guidelines (QIG) [5].
Specific complications such as sepsis,
hemorrhage and death were 3.6%,
2.7% and 1.8% which is well within the complication-specific thresholds of 5,
5 and 3% respectively as recommended by SIR’s QIG.
In conclusion,
vascular complications although rare are a major cause of patient morbidity and mortality and are often due to multiple needle punctures and repeated or vigorous manipulations during percutaneous biliary interventional procedures.