Percutaneous transhepatic cholangiography and biliary decompression. Invasive, diagnostic, and therapeutic procedures with too high a price?
To investigate and/or treat the causes of jaundice, 221 patients underwent the following procedures over 7 years: percutaneous transhepatic cholangiography (PTC) alone (104 patients), PTC with external biliary drainage (69 patients), or PTC with external/internal biliary drainage (48 patients). Forty-nine procedure-related complications occurred in 39 patients (18%). Three patients (1.5%) required an emergency operation for hepatic hemorrhage (2 patients) and a perforated gallbladder (1 patient). Two patients (1%) died as a direct result of the procedure secondary to hemorrhage (1 patient) and sepsis (1 patient). Preoperative biliary decompression, although technically (95%) and physiologically (82%) successful in the majority of patients, had no therapeutic benefit when compared (nonrandomized) with those patients without alleviation of jaundice prior to surgical intervention.
Department of Surgery, University of Texas Health Science Center, San Antonio 78284-7842.
K R
KR
Sirinek
B A
BA
Levine
D000038:Abscess / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002758:Cholangiography / Q000009:adverse effects* / Q000379:methods; D002761:Cholangitis / Q000209:etiology; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D005704:Gallbladder / Q000293:injuries; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008099:Liver / Q000293:injuries; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011300:Preoperative Care; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology
D000900:Anti-Bacterial Agents