Complications of left and right sided percutaneous transhepatic biliary drainage
DOI:
https://doi.org/10.18203/2349-3933.ijam20193286Keywords:
Percutaneous transhepatic biliary drainageAbstract
Background: Percutaneous Transhepatic Biliary Drainage (PTBD) is performed either via right or left-ductal approach, on the basis of status of primary confluence, secondary confluence and atrophy of liver parenchyma. Our study compares the complications of two approaches in malignant obstruction. The objectives of this study was to assess and compare complications of PTBD.
Methods: This study was a prospective hospital based study performed for a period of 2 years from 2016 to 2018.
PTBD was performed either via right in 16 patients or left-ductal approach in 15 patients, on the basis of status of primary biliary confluence and atrophy of liver parenchyma.
Results: Both minor and major complications were more common in right-sided approach as compared to left-sided approach with most common major and minor complication being cholangitis (16.12%) and fever (12.9%) respectively.
Conclusions: PTBD is an excellent palliative procedure to drain the bile ducts in malignant obstruction. Although complications of PTBD are more common in right sided approach but results are statistically insignificant.
References
Ballinger AB, McHugh M, Catnach SM, Alstead EM, Clark ML. Symptom relief and quality of life after stenting for malignant bile duct obstruction. Gut. 1994;1;35(4):467-70.
Abraham NS, Barkun JS, Barkun AN. Palliation of malignant biliary obstruction: a prospective trial examining impact on quality of life. Gastrointestinal Endoscopy. 2002;1;56(6):835-41.
Sauvanet A, Boher JM, Paye F, Bachellier P, Cuhna AS, Le Treut YP, et al. Severe jaundice increases early severe morbidity and decreases long-term survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. J Am Coll Surg. 2015;221(2):380-9.
Bonnel D, Andre T, Mader B, Lefebvre JF, Bensoussan E, Liguory C. Malignant biliary obstruction, general review and clinical practice. Bull Cancer. 2013;100(5):443-52.
Deviere J, Baize M, Gelin M, Buset M, Desmarez B, de Toeuf J et al. Treatment of cancer of the head of the pancreas. Surgery and/or endoscopic prostheses. Acta Gastro-enterol Belgica. 1987;50(1):137.
Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma. New England J Med. 2014;11;371(11):1039-49.
Burke EC, Jarnagin WR, Hochwald SN, Pisters PW, Fong Y, Blumgart LH. Hilarcholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a prosurgical clinical staging system. Ann Surg. 1998;228(3):385-94.
Albores SJ, Schwartz AM, Batich K, Henson DE. Cancers of the ampulla of vater: demographics, morphology, and survival based on 5,625 cases from the SEER program. J Surg Oncol. 2009;1;100(7):598-605.
Speer A, Christopher R, Russell G, Hatfield AW, Macrae K, Cotton P, et al. Randomised trial of endoscopic versus percutaneous stent insertion in malignant obstructive jaundice. Lancet. 1987; 330(8550):57-62.
van Leeuwen DJ, Huibregtse K, Tytgat GN. Carcinoma of the hepatic confluence 25 years after Klatskin's description: diagnosis and endoscopic management. Seminars liver Dis. 1990;10(02):102-13.
Polydorou AA, Cairns SR, Dowsett JF, Hatfield AR, Salmon PR, Cotton PB, et al. Palliation of proximal malignant biliary obstruction by endoscopic endoprosthesis insertion. Gut. 1991;32:685‑9.
De Palma GD, Galloro G, Siciliano S, Iovino P, Catanzano C. Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction: results of a prospective, randomized, and controlled study. Gastrointest Endosc. 2001;53:547‑53.
Chandrashekhara SH, Gamanagatti S, Singh A, Bhatnagar S. Current status of percutaneous transhepatic biliary drainage in palliation of malignant obstructive jaundice: a review. Indian J Palliative Care. 2016;22(4):378.
Gamanagatti S, Singh T, Sharma R, Srivastava DN, Dash NR, Garg PK. Unilobar versus bilobar biliary drainage: effect on quality of life and bilirubin level reduction. Indian J Palliative Care. 2016;22(1):50.
Baijal SS, Dhiman RK, Gupta S, Sharma BC, Roy S, Agarwal DK, et al. Percutaneous transhepatic biliary drainage in the management of obstructive jaundice. Tropical Gastroenterol Off J Digestive Dis Foundation. 1997;18(4):167-71.
