Adverse Events after Percutaneous Transhepatic Biliary Drainage: A Ten-Year Retrospective Analysis.

Autor:	Antalek M; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Patel ME; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Knight GM; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Malik A; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Husnain A; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Stiff K; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Talwar A; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Reiland A; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Nemcek A Jr; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Salem R; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL., Riaz A; Department of Radiology, Section of Vascular and Interventional Radiology, Northwestern University, Chicago, IL. Electronic address: ahsun-riaz@northwestern.edu.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 Dec 24. Date of Electronic Publication: 2024 Dec 24.
DOI:	10.1016/j.jvir.2024.12.022
Abstrakt:	Purpose: To determine the adverse events (AEs) rate associated with percutaneous transhepatic biliary drainage (PTBD) and identify risk factors for their occurrence. Materials and Methods: This single-center retrospective study included 2310 PTBD (right-side: 1164; left-sided: 966; bilateral: 180) interventions for biliary obstruction (benign/malignant) in 449 patients between 2010-2020. Patients with percutaneous cholecystostomy alone were excluded. There were 455 initial drain placements (66 with cholangioplasty) and 1855 exchanges (202 with cholangioplasty). Stents were placed in 163 procedures (metal: 156; plastic: 86). Demographic and procedural variables were assessed using multivariable logistic regression. Results: A total of 745 AEs were recorded. The three most common AEs were peri-catheter bile leak (331/745; 44.4%), catheter occlusion (110/745; 14.7%), and drain dislodgement (103/745; 13.8%). There was a significantly higher overall AE rate amongst patients with malignant biliary obstruction compared to benign [29.8% vs. 17.6%; p=0.0065; odds ratio (OR)=1.57(1.13-2.18)]. Intra-procedure cholangioplasty was associated with decreased AE rate for initial drains and overall procedures [OR=0.48 (0.25-0.90); p=0.02 and OR=0.63 (0.45-0.89); p=0.0092]. Finally, a right-sided drain was associated with an increased overall AE rate for initial drains and overall procedures [OR=1.62 (1.02-2.55); p=0.04 and OR=1.43 (1.05-1.91); p=0.02]. Conclusion: Malignant obstruction and right-sided drains are associated with a higher risk of PTBD-related AEs, while intra-procedure cholangioplasty reduces risk. These findings offer insights into how this high-impact procedure can be performed more safely and effectively. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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