Percutaneous transhepatic drainage is safe and effective in biliary obstruction-A single-center experience of 599 patients

Autor: Nelli Farkas, Ákos Szücs, Attila Szijártó, Miklós Ujváry, Szabolcs Móri, Adél Kalocsai, Bálint Kokas
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Percutaneous
Cholangitis
Technical success
Constriction
Pathologic
Single Center
Vascular Medicine
Mathematical and Statistical Techniques
Medicine and Health Sciences
Genitourinary Cancers
Major complication
Cholangiopancreatography
Endoscopic Retrograde
Multidisciplinary
Endoscopic retrograde cholangiopancreatography
medicine.diagnostic_test
Standard treatment
Statistics
Metaanalysis
Bladder Cancer
Liver
Oncology
Research Design
Physical Sciences
Drainage
Medicine
Female
Anatomy
Research Article
medicine.medical_specialty
Clinical Research Design
Urology
Science
Surgical and Invasive Medical Procedures
Hemorrhage
Gastroenterology and Hepatology
Research and Analysis Methods
Pancreatic Cancer
Signs and Symptoms
Gastrointestinal Tumors
medicine
Humans
Statistical Methods
Aged
Retrospective Studies
business.industry
Biology and Life Sciences
Cancers and Neoplasms
Endoscopy
Cholestasis
Extrahepatic
medicine.disease
Surgery
Genitourinary Tract Tumors
Stenosis
Pancreatitis
Biliary System
Referral center
Bile Ducts
Adverse Events
Clinical Medicine
business
Mathematics
Zdroj: PLoS ONE, Vol 16, Iss 11, p e0260223 (2021)
PLoS ONE, Vol 16, Iss 11 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Background Historically, surgical bilioenteric bypass was the only treatment option for extrahepatic bile duct obstruction, but with technological advancements, percutaneous transhepatic drainage (PTD) and endoscopic solutions were introduced as a less invasive alternative. Endoscopic methods may lead to a decreasing indication of PTD in the future, but today it is still the standard treatment method, especially in hilar obstructions. Methods In our retrospective data analysis, we assessed technical success rate, reintervention rate, morbidity, mortality, and the learning curve of patients treated with PTD over 12 years in a tertiary referral center. Results 599 patients were treated with 615 percutaneous interventions. 94.5% (566/599) technical success rate; 2.7% (16/599) reintervention rate were achieved. 111 minor and 22 major complications occurred including 1 case of death. In perihilar obstruction, cholangitis were significantly more frequent in cases where endoscopic retrograde cholangiopancreatography had also been performed prior to PTD compared to PTD alone, with 39 (18.2%) and 15 (10.5%) occurrences, respectively. Discussion The results and especially the excellent success rates demonstrate that PTD is safe and effective, and it is appropriate for first choice in the treatment algorithm of perihilar stenosis. Ultimately, we concluded that PTD should be performed in experienced centers to achieve low mortality, morbidity, and high success rates.
Databáze: OpenAIRE
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