Ultrasound-Guided Percutaneous Transhepatic Biliary Drainage Outcome at Tertiary Care Centre of North India
Abstract
Aims: The aim of this study is to know the feasibility and outcome of ultrasound-guided percutaneous transhepatic biliary
drainage (PTBD) at tertiary care center of North India.
Materials and Methods: This is a prospective observational study conducted on patients affected by biliary tree obstruction
with jaundice referred to department of radiodiagnosis for management of obstructive jaundice. Procedure (PTBD) has been
performed by single step puncturing the biliary system under ultrasound guidance.
Results: 110 patients affected by biliary tree obstruction were included in this study. The biliary obstruction was malignant
in 102 and benign in eight cases. Technical success considered as positioning of a drainage tube into the biliary tree by only
ultrasound guidance and single step puncture was 100%.
Conclusions: Only ultrasound guidance to access the biliary tree and single step puncture of bile duct for PTBD was a safe,
low cost, and effective technique for the management of obstructive biliary pathology.
References
transhepatic cholangiography. Ann Surg 1962;156:451-62.
2. Nennstiel S, Treiber M, Faber A, Haller B, von Delius S, Schmid RM,
et al. Comparison of ultrasound and fluoroscopically guided percutaneous
transhepatic biliary drainage. Dig Dis 2019;37:77-86.
3. Makuuchi M, Bandai Y, Ito T, Watanabe G, Wada T, Abe H, et al.
Ultrasonically guided percutaneous transhepatic bile drainage: A singlestep
procedure without cholangiography. Radiology 1980;136:165-9.
4. Sukigara M, Taguchi Y, Watanabe T, Koshizuka S, Koyama I, Omoto R.
Percutaneous transhepatic biliary drainage guided by color Doppler
echography. Abdom Imaging 1994;19:147-9.
5. Lee W, Kim GC, Kim JY, Baik SK, Lee HJ, Kim HJ, et al. Ultrasound and
fluoroscopy guided percutaneous transhepatic biliary drainage in patients
with nondilated bile ducts. Abdom Imaging 2008;33:555-9.
6. Takada T, Yasuda H, Hanyu F. Technique and management of percutaneous
transhepatic cholangial drainage for treating an obstructive jaundice.
Hepatogastroenterology 1995;42:317-22.
7. Righi D, Doriguzzi A, Rampado O, Savio L, Faletti R, Caggiula P, et al.
Interventional procedures for biliary drainage with bilioplasty in paediatric
patients: Dosimetric aspects. Radiol Med 2008;113:429-38.
8. Houghton EJ, Zeledon M, Acquafresca P, Finger C, Palermo M, Gimenez
ME. Prospective comparison of bleeding complications between right and
left approaches in percutaneous biliary drainage. Surg Laparosc Endosc
Percutan Tech 2019;29:7-12.
9. Corvino F, Centore L, Soreca E, Corvino A, Farbo V, Bencivenga A.
Percutaneous “Y” biliary stent placement in palliative treatment of Type 4
malignant hilar stricture. J Gastrointest Oncol 2016;7:255-61.
10. 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;21:789-95.
11. Kühn JP, Busemann A, Lerch MM, Heidecke CD, Hosten N, Puls R.
Percutaneous biliary drainage in patients with nondilated intrahepatic bile
ducts compared with patients with dilated intrahepatic bile ducts. AJR Am J
Roentgenol 2010;195:851-7.
12. Oh HC, Lee SK, Lee TY, Kwon S, Lee SS, Seo DW, et al. Analysis of
percutaneous transhepatic cholangioscopy-related complications and the
risk factors for those complications. Endoscopy 2007;39:731-6.
13. Weber A, Gaa J, Rosca B, Born P, Neu B, Schmid RM, et al. Complications
of percutaneous transhepatic biliary drainage in patients with dilated and
nondilated intrahepatic bile ducts. Eur J Radiol 2009;72:412-7.
14. Wagner A, Mayr C, Kiesslich T, Berr F, Friesenbichler P, Wolkersdörfer GW.
Reduced complication rates of percutaneous transhepatic biliary drainage
with ultrasound guidance. J Clin Ultrasound 2017;45:400-7.