Clinical outcomes of percutaneous transhepatic biliary drainage in the management of malignant biliary obstruction
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Abstract
This study aimed to evaluate the clinical outcomes of percutaneous transhepatic biliary drainage (PTBD) in the management of malignant biliary obstruction at Can Tho Oncology Hospital. A descriptive case series was conducted on 34 patients with malignant obstructive jaundice who underwent PTBD between March 2023 and September 2025. The technical success rate was 94.2%. One week after the intervention, the total bilirubin level decreased by an average of 40 – 50%, from 187.6 ± 40 µmol/L to 108.8 ± 44 µmol/L (p < 0.001). Liver enzyme levels (AST, ALT) decreased, and the prothrombin ratio significantly improved from 54 ± 9% to 64 ± 9% (p < 0.001). Intraprocedural biliary bleeding occurred in 3.1% of cases. Common post-procedural complications included catheter occlusion (9.3%), bile leakage (6.3%), and biliary tract infection (6.3%). Notably, 15.6% of patients successfully had their drainage catheters removed following specific oncologic treatments. In conclusion, PTBD is a safe and effective intervention for the treatment of malignant biliary obstruction, contributing to the improvement of liver function and general condition, and facilitating subsequent oncologic treatments.
Article Details
Keywords
percutaneous transhepatic biliary drainage, malignant biliary obstruction
References
2. Freeman ML. Adverse outcomes of ERCP. Gastrointest Endosc. 2002;56(6 Suppl):S273-S282. doi:10.1067/mge.2002.129028
3. Das M, van der Leij C, Katoh M, et al. CIRSE Standards of Practice on Percutaneous Transhepatic Cholangiography, Biliary Drainage and Stenting. Cardiovasc Intervent Radiol. 2021;44(10):1499-1509. doi:10.1007/s00270-021-02903-4
4. Zhang GY, Li WT, Peng WJ, et al. Clinical outcomes and prediction of survival following percutaneous biliary drainage for malignant obstructive jaundice. Oncol Lett. 2014;7(4):1185-1190. doi:10.3892/ol.2014.1860
5. Saad WE, Wallace MJ, Wojak JC, et al. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 2010;21(6):789-795. doi:10.1016/j.jvir.2010.01.012
6. Pugh RN, Murray-Lyon IM, Dawson JL, et al. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-649. doi:10.1002/bjs.1800600817
7. Wang Y, Wen N, Xiong X, et al. Biliary drainage in malignant biliary obstruction: an umbrella review of randomized controlled trials. Front Oncol. 2023;13:1235490. Published 2023 Sep 5. doi:10.3389/fonc.2023.1235490
8. Chung Hoàng Phương, Nguyễn Đình Luân, Trần Minh Hiền, và cs. Kết quả dẫn lưu, đặt stent kim loại đường mật xuyên gan qua da ở bệnh nhân tắc mật do ung thư tiến xa. Tạp chí Y học Thành phố Hồ Chí Minh. 2017;21(1):18-35.
9. Giurazza F, Corvino F, Contegiacomo A, et al. Safety and effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage: a multicenter experience. J Ultrasound. 2019;22:437-445.
10. Đỗ Quang Út, Nguyễn Tiến Thịnh, Nguyễn Khánh Trạch. Đánh giá kết quả đặt stent đường mật qua nội soi mật tụy ngược dòng trong điều trị tắc mật do ung thư. Tạp chí Y Dược Lâm sàng 108. 2021;16(8):27-37. doi:10.52389/ydls.v16i8.954
11. Ferraz Gonçalves JA, Rosendo E, Sousa L, et al. Complications of Biliary Drainage in Patients with Malignant Biliary Obstruction. J Gastrointest Cancer. 2021;52(3):1067-1072. doi:10.1007/s12029-020-00541-6
12. Ravindra KV, Stringer MD, Prasad KR, et al. Non-Hodgkin lymphoma presenting with obstructive jaundice. Br J Surg. 2003;90(7):845-849. doi:10.1002/bjs.4119