Selles, K.D.C. (2012) De Resultaten van 103 Percutane Transhepatische Cholangiodrainages. thesis, Medicine.
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Abstract
Background: The percutaneous transhepatic biliary drainage (PTBD) is a generally accepted procedure to treat obstructions and biliary leaks caused by surgery, whether benign or malign. This technique has been proven a safe and effective procedure. For permanent drainage self-expandable metallic stents are used (Wallstents). Temporarily drainage is obtained by inserting a Lunderquist-Ring catheter. This single-center retrospective study will evaluate the results of the PTBDs with internal drainage as intention to treat. Methods: 103 patients were included. Distinction was made between obstruction and biliary leaks. The obstructions were divided in a malign cause and a benign cause. A malign cause for obstruction was again divided in permanent and temporarily drainage. Success rate, patency, survival rate and complications were recorded. Results: The intention to treat was successfully reached in 90.3% of all patients. Reinterventions were made in 27.2% of all patients with a median stent patency of 17.5 days (2 – 216). The median survival was 40 months (0 – 47.1) with a 30-day mortality of 35.0%. Deceased patients were older than patients not deceased at the end of the study. The patients who underwent permanent drainage accounted for 59.2% of total. The stentpatency was 66.0 days (2 – 216). The 30-day mortality was 32.9% with 1 procedure-related death. Complications occurred in 14.8% of patients. A cholangiocarcinoma required more tempi before successful placement. Patients with a Klatskins tumor or a pancreatic tumor underwent more reinterventions. PTBDs implemented for benign obstructions (16.5%) had a succesrate of 94.2% without any complications. Conclusion: Success rates, length of survival, 30-day mortality and complications in this center were similar to those described in literature regarding permanent drainage. The stentpatency did differ, literature describes a longer median patency. Different tumors tend to influence the number of tempi and reinterventions needed. The results of the treated benign obstructions were better than expected compared to the literature. Further prospective research should give more adequate and more representative results.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair Begeleider: and Bezooijen, Drs. R.J. Radioloog MST Enschede |
| Supervisor name: | Huisman Dr. A.B. Interventieradioloog MST Enschede |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/513 |
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