Percutaneous transhepatic cholangiography and drainage. Risks and complications.
An analysis of 237 consecutive PTC/PTD procedures revealed radiographically demonstrable complications in 21 per cent (50/237 cases: bile-contrast medium leakage 24 cases, haemobilia 18 cases) and clinically registered complications in 11% (26/237 cases: bile or blood leakage with or without peritonitis in 10 cases). Two deaths occurred. When possible, a drainage catheter was inserted for decompression. This was performed on 184 occasions in 139 patients--failure rate was 5 per cent. Unsuccessful attempt to introduce a drainage catheter constituted a major complication risk occurring in 5/13 cases (38%). Signs of infection were frequent though these complications were not a major problem in this series. Various possibilities to reduce complications and infections are discussed.
D002759:Adenoma, Bile Duct / Q000601:surgery; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D002758:Cholangiography / Q000009:adverse effects*; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000209:etiology; D005260:Female; D042882:Gallstones / Q000601:surgery; D006431:Hemobilia / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D010538:Peritonitis / Q000209:etiology; D011677:Punctures / Q000009:adverse effects