Open AccessPercutaneous‐transhepatic‐endoscopic rendezvous procedures are effective and safe in patients with refractory bile duct obstruction
Author(s) -
Bokemeyer Arne,
Müller Friederike,
Niesert Hannah,
Brückner Markus,
Bettenworth Dominik,
Nowacki Tobias,
Beyna Torsten,
Ullerich Hansjörg,
Lenze Frank
Publication year - 2019
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640619825949
Subject(s) - medicine , percutaneous transhepatic cholangiography , percutaneous , cohort , surgery , refractory (planetary science) , pancreatitis , radiology , bile duct , cholangiography , balloon dilation , balloon , physics , astrobiology
Background Percutaneous‐transhepatic‐endoscopic rendezvous procedures (PTE‐RVs) are rescue approaches used to facilitate biliary drainage. Objective The objective of this article is to evaluate the safety and the technical success of PTE‐RVs in comparison with those of percutaneous transhepatic cholangiographies (PTCs). Methods Percutaneous procedures performed over a 10‐year period were retrospectively analyzed in a single‐center cohort. Examinations were performed because of a previous or expected failure of standard endoscopic methods including endoscopic retrograde cholangiography (ERC) or balloon‐assisted ERC to achieve biliary access. Results In total, 553 percutaneous procedures including 163 PTE‐RVs and 390 PTCs were performed. Overall, 71.3% of the patients suffered from malignant disease with pancreas‐carcinoma (32.8%) and cholangio‐carcinoma (19.0%) as the most frequent, while 28.7% of the patients suffered from benign disease. Many patients had a postoperative change in bowel anatomy (50.8%). PTC had a higher technical success rate (89.7%); however, the technical success rate of PTE‐RVs was still high (80.4%; p < 0.003). Overall complications occurred in 23.5% of all procedures. Significantly fewer complications occurred after performing PTE‐RVs than after PTCs (16.6% vs 26.4%; p = 0.037). Conclusion Beside a high technical efficacy of PTE‐RVs, significantly fewer complications occur following PTE‐RVs than following PTCs; thus, PTE‐RV should be preferred over PTC alone in selected patients.