Cargando…

Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience

Percutaneous transhepatic biliary drainage (PTBD) has been an effective treatment to access the biliary tree, especially in case of endoscopically inaccessible biliary tree. In general, PTBD techniques are divided into two methods: fluoroscopy-guided PTBD and ultrasound (US)-guided PTBD. This study...

Descripción completa

Detalles Bibliográficos
Autores principales: Park, Sung Eun, Nam, In Chul, Baek, Hye Jin, Ryu, Kyeong Hwa, Lim, Sung Gong, Won, Jung Ho, Kim, Doo Ri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635691/
https://www.ncbi.nlm.nih.gov/pubmed/36331963
http://dx.doi.org/10.1371/journal.pone.0277272
_version_ 1784824762517684224
author Park, Sung Eun
Nam, In Chul
Baek, Hye Jin
Ryu, Kyeong Hwa
Lim, Sung Gong
Won, Jung Ho
Kim, Doo Ri
author_facet Park, Sung Eun
Nam, In Chul
Baek, Hye Jin
Ryu, Kyeong Hwa
Lim, Sung Gong
Won, Jung Ho
Kim, Doo Ri
author_sort Park, Sung Eun
collection PubMed
description Percutaneous transhepatic biliary drainage (PTBD) has been an effective treatment to access the biliary tree, especially in case of endoscopically inaccessible biliary tree. In general, PTBD techniques are divided into two methods: fluoroscopy-guided PTBD and ultrasound (US)-guided PTBD. This study aimed to evaluate the effectiveness of US-guided PTBD, focusing on radiation exposure according to intrahepatic duct (IHD) dilatation degree, differences between right- and left-sided approaches and differences between benign and malignant biliary stenosis/obstruction. We evaluated technical success, clinical success, procedural data (the number of liver capsule punctures, procedural time, fluoroscopy time and radiation dose), and procedure-related complications. During the study period, a total of 123 patients with biliary stenosis/obstruction or bile leakage were initially eligible. We excluded 76 patients treated with only ERCP or initially treated with ERCP followed underwent PTBD insertion. Finally, a total of 50 procedures were performed in 47 patients. Of the 47 patients, 8 patients had anatomical alteration due to previous surgery, 6 patients refused ERCP, and 3 patients failed ERCP. For the remaining 30 patients, PTBD was performed on weekend or at night, 11 of whom had poor general condition, 10 patients underwent ERCP 3 to 4 days later after PTBD insertion, 6 patients improved after PTBD insertion without ERCP, 1 patient died, and 1 patient was referred to other hospital. Remaining 1 patient underwent surgery due to Mirizzi syndrome. All procedures were performed by two interventional radiologists. Technical success rate was 100%, clinical success was 94%, and the complication rate was 10%. Fluoroscopy time and the reported radiation dose were significantly lower in patients with dilated bile ducts than in those with non-dilated bile ducts, when biliary puncture under US guidance was performed initially. However, even in patients with non-dilated bile ducts undergoing initial trials of biliary puncture under US guidance, the fluoroscopy time and the reported radiation dose were low, based on current studies. No statistical significant differences were observed in terms of technical and dosimetry results according to right-sided and left-sided procedures and benign and malignant biliary stenosis/obstruction. Thus, US-guided PTBD was found to be a safe and effective technique that significantly reduced fluoroscopy time and radiation doses.
format Online
Article
Text
id pubmed-9635691
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-96356912022-11-05 Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience Park, Sung Eun Nam, In Chul Baek, Hye Jin Ryu, Kyeong Hwa Lim, Sung Gong Won, Jung Ho Kim, Doo Ri PLoS One Research Article Percutaneous transhepatic biliary drainage (PTBD) has been an effective treatment to access the biliary tree, especially in case of endoscopically inaccessible biliary tree. In general, PTBD techniques are divided into two methods: fluoroscopy-guided PTBD and ultrasound (US)-guided PTBD. This study aimed to evaluate the effectiveness of US-guided PTBD, focusing on radiation exposure according to intrahepatic duct (IHD) dilatation degree, differences between right- and left-sided approaches and differences between benign and malignant biliary stenosis/obstruction. We evaluated technical success, clinical success, procedural data (the number of liver capsule punctures, procedural time, fluoroscopy time and radiation dose), and procedure-related complications. During the study period, a total of 123 patients with biliary stenosis/obstruction or bile leakage were initially eligible. We excluded 76 patients treated with only ERCP or initially treated with ERCP followed underwent PTBD insertion. Finally, a total of 50 procedures were performed in 47 patients. Of the 47 patients, 8 patients had anatomical alteration due to previous surgery, 6 patients refused ERCP, and 3 patients failed ERCP. For the remaining 30 patients, PTBD was performed on weekend or at night, 11 of whom had poor general condition, 10 patients underwent ERCP 3 to 4 days later after PTBD insertion, 6 patients improved after PTBD insertion without ERCP, 1 patient died, and 1 patient was referred to other hospital. Remaining 1 patient underwent surgery due to Mirizzi syndrome. All procedures were performed by two interventional radiologists. Technical success rate was 100%, clinical success was 94%, and the complication rate was 10%. Fluoroscopy time and the reported radiation dose were significantly lower in patients with dilated bile ducts than in those with non-dilated bile ducts, when biliary puncture under US guidance was performed initially. However, even in patients with non-dilated bile ducts undergoing initial trials of biliary puncture under US guidance, the fluoroscopy time and the reported radiation dose were low, based on current studies. No statistical significant differences were observed in terms of technical and dosimetry results according to right-sided and left-sided procedures and benign and malignant biliary stenosis/obstruction. Thus, US-guided PTBD was found to be a safe and effective technique that significantly reduced fluoroscopy time and radiation doses. Public Library of Science 2022-11-04 /pmc/articles/PMC9635691/ /pubmed/36331963 http://dx.doi.org/10.1371/journal.pone.0277272 Text en © 2022 Park et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Park, Sung Eun
Nam, In Chul
Baek, Hye Jin
Ryu, Kyeong Hwa
Lim, Sung Gong
Won, Jung Ho
Kim, Doo Ri
Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title_full Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title_fullStr Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title_full_unstemmed Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title_short Effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: A single-center experience
title_sort effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage to reduce radiation exposure: a single-center experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635691/
https://www.ncbi.nlm.nih.gov/pubmed/36331963
http://dx.doi.org/10.1371/journal.pone.0277272
work_keys_str_mv AT parksungeun effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT naminchul effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT baekhyejin effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT ryukyeonghwa effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT limsunggong effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT wonjungho effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience
AT kimdoori effectivenessofultrasoundguidedpercutaneoustranshepaticbiliarydrainagetoreduceradiationexposureasinglecenterexperience