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Reduced complication rates of percutaneous transhepatic biliary drainage with ultrasound guidance
Author(s) -
Wagner Andrej,
Mayr Christian,
Kiesslich Tobias,
Berr Frieder,
Friesenbichler Paul,
Wolkersdörfer Gernot W.
Publication year - 2017
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22461
Subject(s) - medicine , complication , surgery , percutaneous , hematoma , malignancy , fistula , ultrasound , interventional radiology , biliary fistula , radiology
Background We aimed to analyze the benefits of adding ultrasound (US) guidance to the standard fluoroscopically assisted percutaneous transhepatic biliary drainage (F‐PTBD). We also performed a systematic literature review of success and complication rates of US‐PTBD in a wide field of indications. Methods We evaluated a total of 81 US‐PTBDs carried out in our institution, 74% of which were part of the management of malignancy. In addition, we compared our results with those of a total of 5,272 procedures (3,779 F‐PTBD and 1,493 US‐PTBD) reported in the literature. Results US‐PTBD was technically successful in 94% of attempts with a mean of 2.2 needle passes. Procedural success was achieved in 86% of cases. There were no procedure‐related deaths or severe complications. Minor complications were catheter dislodgement (15%) as well as one case each of a porto‐biliary fistula, hematoma, and biloma. A systematic review of the literature also showed that US‐PTBD has a similar technical success rate to F‐PTBD but lower median rates of severe early complications (0% versus 8%) and procedural death (0% versus 1%). Conclusions Given our results and our review of the literature, US‐PTBD is as effective as F‐PTBD and has significantly lower complication rates. US‐PTBD should be preferred to F‐PTBD. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45 :400–407, 2017