Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement

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Abstract

Purpose: To examine outcomes and complications of percutaneous transhepatic biliary drainage (PTBD) performed via the right or left lobe and different entry levels (lobar, segmental, subsegmental, sub-subsegmental). Methods: The records of patients who underwent PTBD for obstructive jaundice from 2008 to 2015 were retrospectively reviewed. Logistic regression analysis was performed to determine factors associated with outcomes and complications based on entry side and entry level. PTBD success was defined as a total bilirubin decrease after catheter placement. Results: The data of 446 patients (mean age 68.4 years) were included. Multivariate logistic regression revealed a decrease of bilirubin level was associated with left lobe (vs. right) entry [adjusted odds ratio (aOR) = 2.657, 95% confidence interval (CI) 1.160, 6.087], external drainage (aOR = 2.908, 95% CI 1.226, 6.897), and liver volume undrained <50% (aOR = 2.623, 95% CI 1.045, 6.581). PTBD success was increased with left lobe entry (aOR = 1.853, 95% CI 1.167, 2.940) and associated with entry level (subsegmental vs. lobar, aOR = 2.992, 95% CI 1.258, 7.114; sub-subsegmental vs. lobar, aOR = 3.711, 95% CI 1.383, 9.956). Complications were significantly decreased with left lobe entry (aOR = 0.450, 95% CI 0.263, 0.769) and associated with entry level (segmental vs. lobar, aOR = 0.359, 95% CI 0.148, 0.873; subsegmental vs. lobar, aOR = 0.248, 95% CI 0.10, 0.615; sub-subsegmental vs. lobar, aOR = 0.129, 95% CI 0.041, 0.411). Conclusions: The success and complications of PTBD vary with entry side and level.

Original languageEnglish
Pages (from-to)713-722
Number of pages10
JournalAbdominal Radiology
Volume43
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

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Drainage
Catheters
Odds Ratio
Confidence Intervals
Liver
Bilirubin
Logistic Models
Obstructive Jaundice
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

@article{315595ce4c0646aa82369c4be4019867,
title = "Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement",
abstract = "Purpose: To examine outcomes and complications of percutaneous transhepatic biliary drainage (PTBD) performed via the right or left lobe and different entry levels (lobar, segmental, subsegmental, sub-subsegmental). Methods: The records of patients who underwent PTBD for obstructive jaundice from 2008 to 2015 were retrospectively reviewed. Logistic regression analysis was performed to determine factors associated with outcomes and complications based on entry side and entry level. PTBD success was defined as a total bilirubin decrease after catheter placement. Results: The data of 446 patients (mean age 68.4 years) were included. Multivariate logistic regression revealed a decrease of bilirubin level was associated with left lobe (vs. right) entry [adjusted odds ratio (aOR) = 2.657, 95{\%} confidence interval (CI) 1.160, 6.087], external drainage (aOR = 2.908, 95{\%} CI 1.226, 6.897), and liver volume undrained <50{\%} (aOR = 2.623, 95{\%} CI 1.045, 6.581). PTBD success was increased with left lobe entry (aOR = 1.853, 95{\%} CI 1.167, 2.940) and associated with entry level (subsegmental vs. lobar, aOR = 2.992, 95{\%} CI 1.258, 7.114; sub-subsegmental vs. lobar, aOR = 3.711, 95{\%} CI 1.383, 9.956). Complications were significantly decreased with left lobe entry (aOR = 0.450, 95{\%} CI 0.263, 0.769) and associated with entry level (segmental vs. lobar, aOR = 0.359, 95{\%} CI 0.148, 0.873; subsegmental vs. lobar, aOR = 0.248, 95{\%} CI 0.10, 0.615; sub-subsegmental vs. lobar, aOR = 0.129, 95{\%} CI 0.041, 0.411). Conclusions: The success and complications of PTBD vary with entry side and level.",
author = "Yi-Sheng Liu and Chia-Ying Lin and Ming-Tsung Chuang and Yi-Shan Tsai and Chien-Kuo Wang and Ming-Ching Ou",
year = "2018",
month = "3",
day = "1",
doi = "10.1007/s00261-017-1258-5",
language = "English",
volume = "43",
pages = "713--722",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Success and complications of percutaneous transhepatic biliary drainage are influenced by liver entry segment and level of catheter placement

AU - Liu, Yi-Sheng

AU - Lin, Chia-Ying

AU - Chuang, Ming-Tsung

AU - Tsai, Yi-Shan

AU - Wang, Chien-Kuo

AU - Ou, Ming-Ching

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Purpose: To examine outcomes and complications of percutaneous transhepatic biliary drainage (PTBD) performed via the right or left lobe and different entry levels (lobar, segmental, subsegmental, sub-subsegmental). Methods: The records of patients who underwent PTBD for obstructive jaundice from 2008 to 2015 were retrospectively reviewed. Logistic regression analysis was performed to determine factors associated with outcomes and complications based on entry side and entry level. PTBD success was defined as a total bilirubin decrease after catheter placement. Results: The data of 446 patients (mean age 68.4 years) were included. Multivariate logistic regression revealed a decrease of bilirubin level was associated with left lobe (vs. right) entry [adjusted odds ratio (aOR) = 2.657, 95% confidence interval (CI) 1.160, 6.087], external drainage (aOR = 2.908, 95% CI 1.226, 6.897), and liver volume undrained <50% (aOR = 2.623, 95% CI 1.045, 6.581). PTBD success was increased with left lobe entry (aOR = 1.853, 95% CI 1.167, 2.940) and associated with entry level (subsegmental vs. lobar, aOR = 2.992, 95% CI 1.258, 7.114; sub-subsegmental vs. lobar, aOR = 3.711, 95% CI 1.383, 9.956). Complications were significantly decreased with left lobe entry (aOR = 0.450, 95% CI 0.263, 0.769) and associated with entry level (segmental vs. lobar, aOR = 0.359, 95% CI 0.148, 0.873; subsegmental vs. lobar, aOR = 0.248, 95% CI 0.10, 0.615; sub-subsegmental vs. lobar, aOR = 0.129, 95% CI 0.041, 0.411). Conclusions: The success and complications of PTBD vary with entry side and level.

AB - Purpose: To examine outcomes and complications of percutaneous transhepatic biliary drainage (PTBD) performed via the right or left lobe and different entry levels (lobar, segmental, subsegmental, sub-subsegmental). Methods: The records of patients who underwent PTBD for obstructive jaundice from 2008 to 2015 were retrospectively reviewed. Logistic regression analysis was performed to determine factors associated with outcomes and complications based on entry side and entry level. PTBD success was defined as a total bilirubin decrease after catheter placement. Results: The data of 446 patients (mean age 68.4 years) were included. Multivariate logistic regression revealed a decrease of bilirubin level was associated with left lobe (vs. right) entry [adjusted odds ratio (aOR) = 2.657, 95% confidence interval (CI) 1.160, 6.087], external drainage (aOR = 2.908, 95% CI 1.226, 6.897), and liver volume undrained <50% (aOR = 2.623, 95% CI 1.045, 6.581). PTBD success was increased with left lobe entry (aOR = 1.853, 95% CI 1.167, 2.940) and associated with entry level (subsegmental vs. lobar, aOR = 2.992, 95% CI 1.258, 7.114; sub-subsegmental vs. lobar, aOR = 3.711, 95% CI 1.383, 9.956). Complications were significantly decreased with left lobe entry (aOR = 0.450, 95% CI 0.263, 0.769) and associated with entry level (segmental vs. lobar, aOR = 0.359, 95% CI 0.148, 0.873; subsegmental vs. lobar, aOR = 0.248, 95% CI 0.10, 0.615; sub-subsegmental vs. lobar, aOR = 0.129, 95% CI 0.041, 0.411). Conclusions: The success and complications of PTBD vary with entry side and level.

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U2 - 10.1007/s00261-017-1258-5

DO - 10.1007/s00261-017-1258-5

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JO - Abdominal Radiology

JF - Abdominal Radiology

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