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.
Sirinek
K R
KR
Department of Surgery, University of Texas Health Science Center, San Antonio 78284-7842.
Levine
B A
BA
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