Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1983 Jul;198(1):25–29.

Percutaneous transhepatic biliary drainage. Complications due to multiple duct obstructions.

M E Clouse, D Evans, P Costello, M Alday, S A Edwards, W V McDermott Jr
PMCID: PMC1352926  PMID: 6859989

Abstract

The medical histories of fifty-three consecutive patients who were scheduled for percutaneous transhepatic biliary drainage (PTBD) were reviewed for incidents of sepsis. Among the 52 patients who were successfully catheterized, there were 14 incidents of sepsis, three incidents of abscess and sepsis, and two incidents of sepsis following a pulled catheter (a total incidence of 36.5%). In 14 instances, the sepsis was attributed primarily to the presence of enteric bacteria combined with bile stasis caused by multiple duct obstruction from disseminated malignancy. The presence of bacteria in the bile of well-drained patients did not necessarily lead to sepsis. This series highlights the importance of medical alert for signs of sepsis in biliary drainage patients and suggests that external drainage is preferable in patients with incomplete emptying of the biliary system during PTBD.

Full text

PDF
25

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aston S. J., Longmire W. P., Jr Pancreaticoduodenal resection. Twenty years' experience. Arch Surg. 1973 Jun;106(6):813–817. doi: 10.1001/archsurg.1973.01350180047015. [DOI] [PubMed] [Google Scholar]
  2. BUCKWALTER J. A., LAWTON R. L., TIDRICK R. T. BYPASS OPERATIONS FOR NEOPLASTIC BILIARY TRACT OBSTRUCTION. Am J Surg. 1965 Jan;109:100–106. doi: 10.1016/s0002-9610(65)80110-6. [DOI] [PubMed] [Google Scholar]
  3. Berquist T. H., May G. R., Johnson C. M., Adson M. A., Thistle J. L. Percutaneous biliary decompression: internal and external drainage in 50 patients. AJR Am J Roentgenol. 1981 May;136(5):901–906. doi: 10.2214/ajr.136.5.901. [DOI] [PubMed] [Google Scholar]
  4. Blenkharn J. I., McPherson G. A., Blumgart L. H. An improved system for external biliary drainage. Lancet. 1981 Oct 10;2(8250):781–782. doi: 10.1016/s0140-6736(81)90189-6. [DOI] [PubMed] [Google Scholar]
  5. Braasch J. W., Gray B. N. Considerations that lower pancreatoduodenectomy mortality. Am J Surg. 1977 Apr;133(4):480–484. doi: 10.1016/0002-9610(77)90135-0. [DOI] [PubMed] [Google Scholar]
  6. Brooks J. R., Culebras J. M. Cancer of the pancreas. Palliative operation, Whipple procedure, or total pancreatectomy? Am J Surg. 1976 Apr;131(4):516–520. doi: 10.1016/0002-9610(76)90167-7. [DOI] [PubMed] [Google Scholar]
  7. Feduska N. J., Dent T. L., Lindenauer S. M. Results of palliative operations for carcinoma of the pancreas. Arch Surg. 1971 Aug;103(2):330–334. doi: 10.1001/archsurg.1971.01350080246039. [DOI] [PubMed] [Google Scholar]
  8. Ferrucci J. T., Jr, Mueller P. R., Harbin W. P. Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology. 1980 Apr;135(1):1–13. doi: 10.1148/radiology.135.1.7360943. [DOI] [PubMed] [Google Scholar]
  9. Gudjonsson B., Livstone E. M., Spiro H. M. Cancer of the pancreas: diagnostic accuracy and survival statistics. Cancer. 1978 Nov;42(5):2494–2506. doi: 10.1002/1097-0142(197811)42:5<2494::aid-cncr2820420554>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  10. Hansson J. A., Hoevels J., Simert G., Tylén U., Vang J. Clinical aspects of nonsurgical percutaneous transhepatic bile drainage in obstructive lesions of the extrahepatic bile ducts. Ann Surg. 1979 Jan;189(1):58–61. doi: 10.1097/00000658-197901000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Harbin W. P., Ferrucci J. T., Jr Nonoperative management of malignant biliary obstruction: a radiologic alternative. AJR Am J Roentgenol. 1980 Jul;135(1):103–107. doi: 10.2214/ajr.135.1.103. [DOI] [PubMed] [Google Scholar]
  12. Hertzberg J. Pancreatico-duodenal resection and by-pass operation in patients with carcinoma of the head of the pancreas, ampulla, and distal end of the common duct. Acta Chir Scand. 1974;140(7):523–527. [PubMed] [Google Scholar]
  13. Hoevels J., Lunderquist A., Ihse I. Percutaneous transhepatic intubation of bile ducts for combined internal-external drainage in preoperative and palliative treatment of obstructive jaundice. Gastrointest Radiol. 1978 Apr 15;3(1):23–31. doi: 10.1007/BF01887031. [DOI] [PubMed] [Google Scholar]
  14. Juler G. L., Conroy R. M., Fuelleman R. W. Bile leakage following percutaneous transhepatic cholangiography with the Chiba needle. Arch Surg. 1977 Aug;112(8):954–958. doi: 10.1001/archsurg.1977.01370080052008. [DOI] [PubMed] [Google Scholar]
  15. Maki T., Sato T., Kakizaki G., Sendai Pancreatoduodenectomy for periampullary carcinomas. Appraisal of two-stage procedure. Arch Surg. 1966 Jun;92(6):825–833. doi: 10.1001/archsurg.1966.01320240013004. [DOI] [PubMed] [Google Scholar]
  16. McPherson G. A., Benjamin I. S., Habib N. A., Bowley N. B., Blumgart L. H. Percutaneous transhepatic drainage in obstructive jaundice: advantages and problems. Br J Surg. 1982 May;69(5):261–264. doi: 10.1002/bjs.1800690511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Molnar W., Stockum A. E. Relief of obstructive jaundice through percutaneous transhepatic catheter--a new therapeutic method. Am J Roentgenol Radium Ther Nucl Med. 1974 Oct;122(2):356–367. doi: 10.2214/ajr.122.2.356. [DOI] [PubMed] [Google Scholar]
  18. Nakayama T., Ikeda A., Okuda K. Percutaneous transhepatic drainage of the biliary tract: technique and results in 104 cases. Gastroenterology. 1978 Mar;74(3):554–559. [PubMed] [Google Scholar]
  19. Parkash O. On the statistical and clinical evaluation of carcinoma of the pancreas. A survey of 68 cases. Digestion. 1972;6(3):152–164. doi: 10.1159/000197234. [DOI] [PubMed] [Google Scholar]
  20. Pollock T. W., Ring E. R., Oleaga J. A., Freiman D. B., Mullen J. L., Rosato E. F. Percutaneous decompression of benign and malignant biliary obstruction. Arch Surg. 1979 Feb;114(2):148–151. doi: 10.1001/archsurg.1979.01370260038005. [DOI] [PubMed] [Google Scholar]
  21. Ring E. J., Husted J. W., Oleaga J. A., Freiman D. B. A multihole catheter for maintaining longterm percutaneous antegrade biliary drainage. Radiology. 1979 Sep;132(3):752–754. doi: 10.1148/132.3.752. [DOI] [PubMed] [Google Scholar]
  22. Ring E. J., Oleaga J. A., Freiman D. B., Husted J. W., Lunderquist A. Therapeutic applications of catheter cholangiography. Radiology. 1978 Aug;128(2):333–338. doi: 10.1148/128.2.333. [DOI] [PubMed] [Google Scholar]
  23. Shapiro T. M. Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs Whipple resection in good risk patients. Ann Surg. 1975 Dec;182(6):715–721. doi: 10.1097/00000658-197512000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Suzuki T., Kawabe K., Imamura M., Honjo I. Survival of patients with cancer of the pancreas in relation to findings on arteriography. Ann Surg. 1972 Jul;176(1):37–41. doi: 10.1097/00000658-197207000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Tylén U., Hoevels J., Vang J. Percutaneous transhepatic cholangiography with external drainage of obstructive biliary lesions. Surg Gynecol Obstet. 1977 Jan;144(1):13–18. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES