Outcome and Complications of Percutaneous Transhepatic Biliary Drainage: Influence of Liver Entry Site
Vicky Kumar, Amjad Sattar, Nauman Al Qamari, Hatem Adel, Muneer Sadiq
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ABSTRACT
Objective: To
determine the outcome and complications of percutaneous transhepatic biliary
drainage (PTBD) performed via right lobe and left lobe duct puncture.
Study Design: Cross-sectional study.
Place and Duration of Study:
Department of Interventional
Radiology, Dow Institute of Radiology, Dow University of Health Sciences from
July 2020 to March 2021.
Methodology: Both adult male and female patients with obstructive jaundice having
dilated intrahepatic biliary ducts on ultrasound were included. PTBD was
performed under ultrasound guidance. Following intrahepatic biliary duct
puncture, a guide wire was inserted followed by placement of 8 Fr or 10 Fr
pigtail drainage catheter. Total bilirubin level was measured before and one
day after the procedure. Cholangiogram was performed 48 hours after the
procedure to check the drain placement and residual dilatation.
Results: 130 patients were included with mean age of 55.3 ± 12.3 years. Success rate
was same in patients with right and left lobe puncture i.e. 96.9%. The
frequency of complication in right lobe puncture was higher (37.5%). Mean
procedure time was significantly higher in patients who developed complications
(75.92 ± 19.20 minutes) as well as mean exposure time was also significantly
higher in patients who developed complications (12.00 ± 6.87 minutes) as
compared to patients who did not develop any complication (8.08 ± 3.43 minutes)
(p <0.05).
Conclusion: It was concluded that the success rate in right and left lobe puncture
was equal and complication rate in right lobe puncture was observed to be high
as compared to left lobe puncture.
Keywords: Biliary drainage, Complications,
Effect, Liver