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Health-Related Quality of Life evaluation in “left” versus “right” access for percutaneous transhepatic biliary drainage using EORTC QLQBIL-21 questionnaire: a randomized controlled trial

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the impact of the different access for percutaneous transhepatic biliary drainage (PTBD) in terms of “Quality of Life” (QoL) in the management of malignant obstructive jaundice.

Methods

In this IRB-approved study, 64 consecutive patients with malignant obstructive jaundice were prospectively randomized to the right (group A) or left access (group B) for PTBD between February 2017 and December 2018. In order to demonstrate differences in terms of QoL between these groups, patients were asked to complete the “EORTC QLQ-BIL21” questionnaire the week after the treatment. Continuous variables were summarized by mean ± SD and compared using a Mann–Whitney U test.

Results

Percutaneous transhepatic biliary drainages were performed through right access in 31 cases and 33 cases through left access. Technical success was achieved in all cases (100%). During 1 week’s follow-up, there was a significant difference between group A and B in terms of pain (p < 0.001). Group A showed higher intercostal pain and respiratory difficulties compared to group B. Moreover, patients of group A showed a higher level of tiredness, anxiety, and more difficult tubes drainage and bags management than group B patients.

Conclusion

In our experience, the use of the questionnaires showed the right access is associated with intercostal pain and respiratory difficulties. Left access for PTBD provides a better Quality of Life for patients who underwent PTBD as palliative treatment for the management of malignant obstructive jaundice and could be considered as the approach of choice in case of distal obstruction.

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References

  1. SH Chandrashekhara, S Gamanagatti, Anuradha Singh, and Sushma Bhatnagar. Current Status of Percutaneous Transhepatic Biliary Drainage in Palliation of Malignant Obstructive Jaundice: A Review. Indian J Palliat Care. 2016 Oct-Dec; 22(4): 378–387.

  2. Kocher M, Cerna M, Havlík R, Kral V, Gryga A, Duda M. Percutaneous treatment of benign bile duct strictures. Eur J Radiol. 2007 May. 62(2):170-4.

    Article  Google Scholar 

  3. Saad WE, Wallace MJ, Wojak JC, Kundu S, Cardella JF. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 2010 Jun;21(6):789-95.

    Article  Google Scholar 

  4. Burke D.R., Lewis C.A., Cardella J.F., Citron S.J., Drooz A.T., Haskal Z.J., Husted J.W. Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography and Biliary Drainage, for the Society of Interventional Radiology Standards of Practice Committee, Journal of Vascular and Interventional Radiology 2003, 14 (9 PART 2), pp. S243-S246.

  5. Kumble Seetharama Madhusudhan, Shivanand Gamanagatti, Deep Narayan Srivastava, and Arun Kumar Gupta. Radiological interventions in malignant biliary obstruction. World J Radiol. 2016 May 28; 8(5): 518–529

  6. Nanda Venkatanarasimha, Karthik Damodharan, Apoorva Gogna, Sum Leong, Chow Wei Too, Ankur Patel, Kiang Hiong Tay, Bien Soo Tan, Richard Lo, Farah Irani.Diagnosis and Management of Complications from Percutaneous Biliary Tract Interventions. RadioGraphics 2017;37(2):665–680

  7. Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med. 1996;334:835–40

    Article  CAS  Google Scholar 

  8. PF Jaques, VS Mandell, DJ Delany, and PH Nath. Percutaneous transhepatic biliary drainage: advantages of the left-lobe subxiphoid approach.1982; vol 145, issue 2; 534.

  9. Hayashi N, Sakai T, Kitagawa M, Kimoto T, Inagaki R, Ishii Y. US-guided left-sided biliary drainage: nine-year experience. Radiology. 1997;204:119–122.

    Article  CAS  Google Scholar 

  10. Rivera-Sanfeliz GM, Assar OS, La Berge JM, Wilson MW, Gordon RL, Ring EJ, Kerlan RK Jr. Incidence of important haemobilia following transhepatic biliary drainage: left-sided versus right-sided approaches. Cardiovasc Interv Radiol. 2004 Mar-Apr;27(2):137-9.

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

    Article  Google Scholar 

  12. Liu YS, Lin CY, Chuang MT, Tsai YS, Wang CK, Ou MC. Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement. Abdom Radiol (NY). 2018 Mar;43(3):713-722.

    Article  Google Scholar 

  13. Kaupp-Roberts SD, Yadegarfar G, Friend E, et al. Validation of the EORTC QLQ-BIL21 questionnaire for measuring quality of life in patients with cholangiocarcinoma and cancer of the gallbladder. British Journal of Cancer. 2016;115(9):1032-1038.

    Article  CAS  Google Scholar 

  14. Patel IJ, Davidson JC, Nikolic B et al. Addendum of newer anticoagulants to the SIR consensus guideline. Journal of Vascular and Interventional Radiology 2013 May;24(5):641-5.

    Article  Google Scholar 

  15. Hatzidakis AA, Charonitakis E, Athanasiou A, Tsetis D, Chlouverakis G, Papamastorakis G, Roussopoulou G, Gourtsoyiannis NC. Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage. Clin Radiol. 2003 Feb;58(2):121-7.

    Article  CAS  Google Scholar 

  16. Lee MJ, Fanelli F, Haage P, Hausegger K, Van Lienden KP. Patient Safety in Interventional Radiology: A CIRSE IR Checklist. Cardiovascular and Interventional Radiology. 2012;35(2):244-246.

    Article  CAS  Google Scholar 

  17. Paik WH, Park YS, Hwang JH, et al. Palliative treatment with self-expandable metallic stents in patients with advanced type III or IV hilar cholangiocarcinoma: a percutaneous versus endoscopic approach. Gastrointest Endosc 2009; 69:55–62

    Article  Google Scholar 

  18. Van Delden, OM & Laméris JS. Percutaneous drainage and stenting for palliation of malignant bile duct obstruction. Eur Radiol 2008; 18: 448.

    Article  Google Scholar 

  19. Friend E, Yadegarfar G, Byrne C, Johnson CD, Sezer O, Pucciarelli S, Pereira SP, Chie W-C, Banfield A and Ramage JK. Development of a questionnaire (EORTC module) to measure quality of life in patients with cholangiocarcinoma and gallbladder cancer, the EORTC QLQ-BIL21. British Journal of Cancer 2011; 104, 587–592.

    Article  CAS  Google Scholar 

  20. Abraham NS, Barkun JS, Barkun AN. Palliation of malignant biliary obstruction: a prospective trial examining impact on quality of life. GastrointestEndosc. 2002;56:835–841.

    Google Scholar 

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

    Article  Google Scholar 

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

    Article  Google Scholar 

  23. Winick, Adam B et al. Complications of percutaneous transhepatic biliary interventions. Techniques in Vascular & Interventional Radiology 2001; Volume 4, Issue 3; 200 – 206.

  24. Venbrux AC, Osterman FA. Percutaneous transhepatic cholangiography and percutaneous biliary drainage: step by step. In: LaBerge JM, Venbrux AC. editors. Biliary Interventions (SCVIR syllabus). The Sociefy of Cardiovascuar and Interventional Radiology, 1995:129-50.

  25. Brian Funaki. Percutaneous Biliary Drainage. Semin Intervent Radiol. 2007 Jun; 24(2): 268–271.

    Article  Google Scholar 

  26. En-Li Shiau, Huei-Lung Liang, Huei-Lung Liang, Huei-Lung Liang, Yih-Huie Lin, Ming-Feng Li, Chia-Ling Chiang, Matt Chiung-Yu Chen, Jer-Shyung Huang, Huay-Ben Pan. The Complication of Hepatic Artery Injuries of 1,304 Percutaneous Transhepatic Biliary Drainage in a Single Institute. J Vasc Interv Radiol. 2017 Jul;28(7):1025-1032.

  27. Joo Hyeong Oh, Yup Yoon, and Choon Hyeong Lee. Percutaneous Transhepatic Biliary Drainage (PTBD): Comparative Data of Right and Left Hepatic Lobe Approach. J Korean Radiol Soc. 1995 Aug;33(2):279-283.

  28. ASCO Special Article: Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. J Clin Oncol 1996, 14: 671–9.

    Article  Google Scholar 

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Acknowledgements

We have to express out appreciation to Roberto Cannella for sharing his pearls of wisdom with us during the course of this research.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Section of Radiological Science, Bi.N.D, University of Palermo, Via del Vespro, 127, 90127, Palermo, Italy

    Davide Castiglione & Cecilia Gozzo

  2. Unità di Radiologia I, Azienda Ospedaliero Universitaria “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95125, Catania, CT, Italy

    Luca Mammino, Stefano Palmucci & Antonio Basile

  3. Diagnostica per Immagini e Radiologia Interventistica, Azienda Ospedaliera per l’Emergenza “Cannizzaro”, Via Messina 829, 95126, Catania, CT, Italy

    Giovanni Failla

Authors
  1. Davide Castiglione
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  2. Cecilia Gozzo
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Corresponding author

Correspondence to Cecilia Gozzo.

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The authors declare that they have no competing 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 individuals participant included in the study.

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Castiglione, D., Gozzo, C., Mammino, L. et al. Health-Related Quality of Life evaluation in “left” versus “right” access for percutaneous transhepatic biliary drainage using EORTC QLQBIL-21 questionnaire: a randomized controlled trial. Abdom Radiol 45, 1162–1173 (2020). https://doi.org/10.1007/s00261-019-02136-7

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  • DOI: https://doi.org/10.1007/s00261-019-02136-7

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