Aims and objectives
To review the technical success,
clinical outcomes,
and complications in patients undergoing percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice and identify predictors of poor outcome (death within 30 days of procedure).
Methods and materials
Retrospective review of 240 procedures performed in 116 patients with obstructive jaundice between January 2015 and October 2017 (34 months) in a singe centre (Leeds Teaching Hospitals NHS Trust). Data was collected from the procedure report on the radiology information system,
and pre-/post-procedure blood results on the hospital patient record system. Statistical analysis was performed using two-tailed T-testing and univarate cox regression analysis (SPSS,
IBM).
Results
Total of 240 procedures performed during study period (patients undergoing more than one procedure in quick succession had their procedures grouped to allow data analysis). The mean patient age was 60. 56% had a malignant cause of obstruction, 29% had benign disease,
and 15% were not specified (Fig 1). 30% had a recent failed endoscopic retrograde cholangiopancreatography (ERCP). The technical success rate was 91%,
with 55% of patients having a definitive intervention (50 stents,
12 angioplasty,
2 stone clearance) (Fig 2),
and the remainder having...
Conclusion
PTBD offers a safe and effective approach to managing selected patients with obstructive jaundice. Patients predisposed to poor outcomes (death within 30 days of procedure) can be predicted according to their pre-procedure blood results; this information can befactored into decisions regarding suitability for PTBD.
Findings and outcomes are comparable to previously published studies from similar sized institutions [1].
Personal information
D.
Stockell - Radiology SpR,
Leeds Teaching Hospitals;
K.
Wardman - Foundation Doctor,
Leeds Teaching Hospitals;
J.
Zhong - Radiology SpR,
Leeds Teaching Hospitals;
S.Burbidge - Consultant radiologist,
Leeds Teaching Hospitals.
References
[1] Tapping et al.
Percutaneous transhepatic biliary drainage (PTBD) with or without stenting - complications,
re-stent rate and a new risk stratification score.
Eur Radiol (2011) 21:1948 - 1955.