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Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement

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Abstract

Purpose

To examine outcomes and complications of percutaneous transhepatic biliary drainage (PTBD) performed via the right or left lobe and different entry levels (lobar, segmental, subsegmental, sub-subsegmental).

Methods

The records of patients who underwent PTBD for obstructive jaundice from 2008 to 2015 were retrospectively reviewed. Logistic regression analysis was performed to determine factors associated with outcomes and complications based on entry side and entry level. PTBD success was defined as a total bilirubin decrease after catheter placement.

Results

The data of 446 patients (mean age 68.4 years) were included. Multivariate logistic regression revealed a decrease of bilirubin level was associated with left lobe (vs. right) entry [adjusted odds ratio (aOR) = 2.657, 95% confidence interval (CI) 1.160, 6.087], external drainage (aOR = 2.908, 95% CI 1.226, 6.897), and liver volume undrained <50% (aOR = 2.623, 95% CI 1.045, 6.581). PTBD success was increased with left lobe entry (aOR = 1.853, 95% CI 1.167, 2.940) and associated with entry level (subsegmental vs. lobar, aOR = 2.992, 95% CI 1.258, 7.114; sub-subsegmental vs. lobar, aOR = 3.711, 95% CI 1.383, 9.956). Complications were significantly decreased with left lobe entry (aOR = 0.450, 95% CI 0.263, 0.769) and associated with entry level (segmental vs. lobar, aOR = 0.359, 95% CI 0.148, 0.873; subsegmental vs. lobar, aOR = 0.248, 95% CI 0.10, 0.615; sub-subsegmental vs. lobar, aOR = 0.129, 95% CI 0.041, 0.411).

Conclusions

The success and complications of PTBD vary with entry side and level.

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References

  1. Fidelman N (2015) Benign biliary strictures: diagnostic evaluation and approaches to percutaneous treatment. Tech Vasc Interv Radiol 18(4):210–217

    Article  PubMed  Google Scholar 

  2. Sutter CM, Ryu RK (2015) Percutaneous management of malignant biliary obstruction. Tech Vasc Interv Radiol 18(4):218–226

    Article  PubMed  Google Scholar 

  3. Chandrashekhara SH, Gamanagatti S, Singh A, Bhatnagar S (2016) Current status of percutaneous transhepatic biliary drainage in palliation of malignant obstructive jaundice: a review. Indian J Palliat Care 22:378–387

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Papadopoulos V, Filippou D, Manolis E, Mimidis K (2007) Haemostasis impairment in patients with obstructive jaundice. J Gastrointestin Liver Dis 16(2):177–186

    PubMed  Google Scholar 

  5. Hara K, Yamao K, Mizuno N, et al. (2016) Endoscopic ultrasonography-guided biliary drainage: who, when, which, and how? World J Gastroenterol 22(3):1297–1303

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Wiggers JK, Coelen RJ, Rauws EA, et al. (2015) Preoperative endoscopic versus percutaneous transhepatic biliary drainage in potentially resectable perihilar cholangiocarcinoma (DRAINAGE trial): design and rationale of a randomized controlled trial. BMC Gastroenterol 15:20. doi:10.1186/s12876-015-0251-0

    Article  PubMed  PubMed Central  Google Scholar 

  7. Shimizu H, Kato A, Takayashiki T, et al. (2015) Peripheral portal vein-oriented non-dilated bile duct puncture for percutaneous transhepatic biliary drainage. World J Gastroenterol 21(44):12628–12634

    Article  PubMed  PubMed Central  Google Scholar 

  8. Winick AB, Waybill PN, Venbrux AC (2001) Complications of percutaneous transhepatic biliary interventions. Tech Vasc Interv Radiol 4(3):200–206

    Article  CAS  PubMed  Google Scholar 

  9. Bret PM, de Stempel JV, Atri M, Lough JO, Illescas FF (1998) Intrahepatic bile duct and portal vein anatomy revisited. Radiology 169(2):405–407

    Article  Google Scholar 

  10. Kitami M, Takase K, Murakami G, et al. (2006) Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography. Radiology 238(1):156–166

    Article  PubMed  Google Scholar 

  11. Cho A, Okazumi S, Yoshinaga Y, et al. (2003) Relationship between left biliary duct system and left portal vein: evaluation with three-dimensional portocholangiography. Radiology 228(1):246–250

    Article  PubMed  Google Scholar 

  12. Jaques PF, Mandell VS, Delany DJ, et al. (1982) Percutaneous transhepatic biliary drainage: advantages of the left-lobe subxiphoid approach. Radiology 145(2):534–536

    Article  CAS  PubMed  Google Scholar 

  13. Hayashi N, Sakai T, Kitagawa M, et al. (1997) US-guided left-sided biliary drainage: nine-year experience. Radiology 204(1):119–122

    Article  CAS  PubMed  Google Scholar 

  14. Rivera-Sanfeliz GM, Assar OS, LaBerge JM, et al. (2004) Incidence of important hemobilia following transhepatic biliary drainage: left-sided versus right-sided approaches. Cardiovasc Interv Radiol 27(2):137–139

    Article  CAS  Google Scholar 

  15. Hamada T, Yasunaga H, Nakai Y, et al. (2015) Severe bleeding after percutaneous transhepatic drainage of the biliary system: effect of antithrombotic agents–analysis of 34 606 cases from a Japanese nationwide administrative database. Radiology 274(2):605–613

    Article  PubMed  Google Scholar 

  16. Catalano OA, Singh AH, Uppot RN, et al. (2008) Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28(2):359–378

    Article  PubMed  Google Scholar 

  17. Fidelman N, Bloom AI, Kerlan RK Jr, et al. (2008) Hepatic arterial injuries after percutaneous biliary interventions in the era of laparoscopic surgery and liver transplantation: experience with 930 patients. Radiology 247(3):880–886

    Article  PubMed  Google Scholar 

  18. Lucatelli P, Corradini SG, Corona M, et al. (2016) Risk factors for immediate and delayed-onset fever after percutaneous transhepatic biliary drainage. Cardiovasc Interv Radiol 39(5):746–755

    Article  Google Scholar 

  19. Sumiyoshi T, Shima Y, Okabayashi T, et al. (2014) Functional discrepancy between two liver lobes after hemilobe biliary drainage in patients with jaundice and bile duct cancer: an appraisal using (99m)Tc-GSA SPECT/CT fusion imaging. Radiology 273(2):444–451

    Article  PubMed  Google Scholar 

  20. Choi SH, Gwon D, Ko GY, et al. (2011) Hepatic arterial injuries in 3110 patients following percutaneous transhepatic biliary drainage. Radiology 261(3):969–975

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Sheng Li Road, Tainan, 704, Taiwan, ROC

    Yi-Sheng Liu, Chia-Ying Lin, Ming-Tsung Chuang, Yi-Shan Tsai, Chien-Kuo Wang & Ming-Ching Ou

Authors
  1. Yi-Sheng Liu
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  2. Chia-Ying Lin
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  3. Ming-Tsung Chuang
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  4. Yi-Shan Tsai
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Correspondence to Ming-Ching Ou.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Liu, YS., Lin, CY., Chuang, MT. et al. Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement. Abdom Radiol 43, 713–722 (2018). https://doi.org/10.1007/s00261-017-1258-5

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  • DOI: https://doi.org/10.1007/s00261-017-1258-5

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