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

<h4>Background</h4> 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. Endo...

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Autores principales:	Bálint Kokas, Attila Szijártó, Nelli Farkas, Miklós Ujváry, Szabolcs Móri, Adél Kalocsai, Ákos Szücs
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/17e43f89ac634f9b8c38f56b13510356
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spelling	oai:doaj.org-article:17e43f89ac634f9b8c38f56b135103562021-11-25T06:19:39ZPercutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients1932-6203https://doaj.org/article/17e43f89ac634f9b8c38f56b135103562021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601527/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> 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. <h4>Methods</h4> 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. <h4>Results</h4> 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. <h4>Discussion</h4> 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.Bálint KokasAttila SzijártóNelli FarkasMiklós UjvárySzabolcs MóriAdél KalocsaiÁkos SzücsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bálint Kokas Attila Szijártó Nelli Farkas Miklós Ujváry Szabolcs Móri Adél Kalocsai Ákos Szücs Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
description	<h4>Background</h4> 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. <h4>Methods</h4> 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. <h4>Results</h4> 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. <h4>Discussion</h4> 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.
format	article
author	Bálint Kokas Attila Szijártó Nelli Farkas Miklós Ujváry Szabolcs Móri Adél Kalocsai Ákos Szücs
author_facet	Bálint Kokas Attila Szijártó Nelli Farkas Miklós Ujváry Szabolcs Móri Adél Kalocsai Ákos Szücs
author_sort	Bálint Kokas
title	Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
title_short	Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
title_full	Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
title_fullStr	Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
title_full_unstemmed	Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients
title_sort	percutaneous transhepatic drainage is safe and effective in biliary obstruction—a single-center experience of 599 patients
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/17e43f89ac634f9b8c38f56b13510356
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Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients

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