Prospective Comparison of Bleeding Complications Between Right and Left Approaches in Percutaneous Biliary Drainage

被引:12
作者
Houghton, Eduardo J. [1 ,2 ,3 ]
Zeledon, Manuel [4 ]
Acquafresca, Pablo [2 ]
Finger, Caetano [2 ,5 ]
Palermo, Mariano [1 ,2 ]
Gimenez, Mariano E. [1 ,2 ]
机构
[1] Univ Buenos Aires, Dept Surg, Buenos Aires, DF, Argentina
[2] DAICIM Fdn, Teaching Assistance & Res Mini Invas Surg, Buenos Aires, DF, Argentina
[3] Hosp Bernardino Rivadavia, Las Heras 2670, Buenos Aires, DF, Argentina
[4] Univ Costa Rica, Dept Surg, San Jose, Costa Rica
[5] Hosp Juan A Fernandez, Buenos Aires, DF, Argentina
关键词
minimally invasive surgical procedures; percutaneous biliary drainage; bleeding complications; RISK; FLUOROSCOPY; OBSTRUCTION; GUIDELINES; EXPERIENCE; MANAGEMENT;
D O I
10.1097/SLE.0000000000000609
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: The present study aimed to determine whether the percentage of bleeding complications differs between the right and the left approaches in percutaneous biliary drainage (PBD) in adult patients. Materials and Methods: This was a prospective, descriptive, nonrandomized comparative and longitudinal study. We included adult patients over 18 years of age who underwent a PBD. We excluded those with a bilateral PBD for the comparative study. Usually, but not exclusively, we performed the right approach under fluoroscopic guidance and the left one under ultrasound and fluoroscopy. Results: Of 150 cases, 63 were performed using the right approach and 61 with the left; 26 were performed with the bilateral. The right approach faced less dilated biliary ducts and more benign diseases. We experienced 20 bleeding complications (13.33%, confidence intervals of 95%=8.3-19.8), 7 in the bilateral approach, 10 in the right approach, and 3 in the left one. The difference between the right and the left approaches was statistically significant (Fisher P=0,04). No procedures were required to obtain hemostasis, and only one patient (0.66%, confidence intervals of 95%=0.009-3.66) (in the right side) required a red blood cell transfusion. We found no related mortality. Conclusions: Global bleeding complications are more likely to appear in the right approach in which less dilated biliary ducts and more benign diseases probably contributed to a higher number of needle passes, portal and hepatic vein punctures, and, therefore, to an increase in the risk of bleeding complications. The significant bleeding complication rate was low (0.66%).
引用
收藏
页码:7 / 12
页数:6
相关论文
共 33 条
[1]  
Burke Dana R, 2003, J Vasc Interv Radiol, V14, pS243
[2]   Results of percutaneous manoeuvres in biliary disease: The Paul Brousse experience [J].
Castaing, Denis ;
Vibert, Eric ;
Bhangui, Prashant ;
Salloum, Chady ;
Smail, Allaoua ;
Adam, Rene ;
Azoulay, Daniel .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (06) :1858-1865
[3]   Hepatic Arterial Injuries in 3110 Patients Following Percutaneous Transhepatic Biliary Drainage [J].
Choi, Sang Hyun ;
Gwon, Dong Il ;
Ko, Gi-Young ;
Sung, Kyu-Bo ;
Yoon, Hyun-Ki ;
Shin, Ji Hoon ;
Kim, Jin Hyoung ;
Kim, Jinoo ;
Oh, Ji Young ;
Song, Ho-Young .
RADIOLOGY, 2011, 261 (03) :969-975
[4]  
Dawson B, 2002, BIOESTADISTICA MED
[5]   Percutaneous imaging-guided interventions for acute biliary disorders in high surgical risk patients [J].
Donkol, Ragab Hani ;
Latif, Nahed Abdel ;
Moghazy, Khaled .
WORLD JOURNAL OF RADIOLOGY, 2010, 2 (09) :358-367
[6]   Meta-analysis of randomized clinical trials on safety and efficacy of biliary drainage before surgery for obstructive jaundice [J].
Fang, Y. ;
Gurusamy, K. S. ;
Wang, Q. ;
Davidson, B. R. ;
Lin, H. ;
Xie, X. ;
Wang, C. .
BRITISH JOURNAL OF SURGERY, 2013, 100 (12) :1589-1596
[7]  
Garcarek J, 2012, ADV CLIN EXP MED, V21, P621
[8]   REVIEW ARTICLE - PERCUTANEOUS TRANS-HEPATIC BILIARY DRAINAGE - EXPERIENCE WITH 311 PROCEDURES [J].
GUNTHER, RW ;
SCHILD, H ;
THELEN, M .
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 1988, 11 (02) :65-71
[9]   Clinical Outcome of Biliary Drainage for Obstructive Jaundice Caused by Colorectal and Gastric Cancers [J].
Kasuga, Akiyoshi ;
Ishii, Hiroshi ;
Ozaka, Masato ;
Matsusaka, Satoshi ;
Chin, Keisho ;
Mizunuma, Nobuyuki ;
Yukisawa, Seigo ;
Matsueda, Kiyoshi ;
Furuse, Junji .
JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 42 (12) :1161-1167
[10]   A Comparative Evaluation of EUS-Guided Biliary Drainage and Percutaneous Drainage in Patients with Distal Malignant Biliary Obstruction and Failed ERCP [J].
Khashab, Mouen A. ;
Valeshabad, Ali Kord ;
Afghani, Elham ;
Singh, Vikesh K. ;
Kumbhari, Vivek ;
Messallam, Ahmed ;
Saxena, Payal ;
El Zein, Mohamad ;
Lennon, Anne Marie ;
Canto, Marcia Irene ;
Kalloo, Anthony N. .
DIGESTIVE DISEASES AND SCIENCES, 2015, 60 (02) :557-565