Keywords:
Dilatation, Stents, Drainage, Angioplasty, Ultrasound, Percutaneous, Fluoroscopy, Interventional non-vascular, Biliary Tract / Gallbladder
Authors:
D. Stockell, K. Wardman, J. Zhong, S. Burbidge; LEEDS/UK
DOI:
10.26044/ecr2019/C-1243
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 drain insertion. 8/50 stents blocked during the study period. The mean time to stent blockage was 12 months. The recorded complication rate was 17%. The most frequent complication was bile leak in the immediate post-operative period (< 24 hours),
and infection in the early post-operative period (1-30 days). The 30 day mortality was 16%. Review of available bereavment summaries on the hospital patient record system did not reveal any instances of the procedure being listed as the cause of death. There was a statistically significant correlation between 30 day mortality and pre-procedure bilirubin (p = 0.018),
white cell count (p = 0.002),
albumin (p = 0.015),
urea (p = 0.009),
creatinine (p = 0.012),
haemaglobin (p = 0.019),
and alkaline phosphotase (p = 0.002) (Figs 3-9).