Percutaneous Transhepatic Biliary Drainage as a Viable Alternative to Failed Endoscopic Retrograde Cholangiopancreatography in Hepatobiliary Disorders: A Retrospective Analysis: Alternative in Hepatobiliary Disorders

Muhammad Asadullah; Nasreen Naz; Amjad Sattar; Nauman Al Qamari; Parvez Ahmed; Zahoor Ahmed

doi:10.54393/pjhs.v5i09.2130

Authors

Muhammad Asadullah Department of Vascular Interventional Radiology, Dow University of Health Sciences Ojha, Karachi, Pakistan
Nasreen Naz Department of Radiology, Dow Institute of Radiology, Karachi, Pakistan
Amjad Sattar Department of Vascular Interventional Radiology, Dow Institute of Radiology, Karachi, Pakistan
Nauman Al Qamari Department of Vascular Interventional Radiology, Dow Institute of Radiology, Karachi, Pakistan
Parvez Ahmed Department of Vascular Interventional Radiology, Dow Institute of Radiology, Karachi, Pakistan
Zahoor Ahmed Department of Vascular Interventional Radiology, Jinnah Post Graduate Medical Centre, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.2130

Keywords:

Mortality, Endoscopic Retrograde Cholangiopancreatography, Percutaneous Transhepatic Biliary Drainage, Hepatobiliary Disorders, Biliary Obstruction

Abstract

The conventional second-line treatment for failed ERCP was Percutaneous Transhepatic Biliary Drainage (PTBD). Because of its high level of success and accessibility, PTBD has evolved into a well-established rescue therapy. Objective: To assess the procedural outcomes of PTBD following a failed ERCP in patients with hepatobiliary disorders. Additionally, it was focused on finding the significant factors that impact PTBD outcomes. Methods: A retrospective descriptive analysis was performed on 128 individuals at Dow Hospital Ojha Campus Karachi, who received PTBD following a failed ERCP. Between January 2023 and March 2024, we evaluated the clinical success rate, post-PTBD complications, and mortality. Results: The mean age of the patients was 65.9+/-11.7 years, and 76 (59.4%) patients were female. The clinical success rate was 77.3%, and complications after PTBD were 20(15.6%). A prolonged hospital stay was reported in 29 (22.7%) patients, and 13 (10.2%) patients died within 30 days. Younger age, etiology, and type of PTBD had a significant association with clinical success (P<0.05). Older age, female patients, and malignant etiology had a higher complication rate and mortality (P<0.05). Conclusions: PTBD provides a safe, effective, and viable alternative approach for patients with hepatobiliary disorders. It has a low rate of complications, a high rate of procedural success, and a low risk of mortality after a failed ERCP. Adverse events were more common in patients with a malignant etiology, older age, and female gender.

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