title: Drainage-related Complications in Percutaneous Transhepatic Biliary Drainage: An Analysis Over 10 Years.
abstract: BACKGROUND
  Procedure-related complications of percutaneous transhepatic biliary drainage (PTBD) have been well documented in the literature. However, relatively restricted data are available concerning drainage-related complication rates in long-term PTBD therapy. The present retrospective study evaluated the extent and the nature of drainage complications during PTBD therapy and associated risk factors for these complications.
  
  
  METHODS
  Between June 1997 and May 2007, a total of 385 patients with PTBD were identified by analyzing the PTBD database and hospital charts, with a total of 2468 percutaneous biliary drainages being identified.
  
  
  RESULTS
  Among the identified patients, 243 (63%) had malignant and 142 (37%) had benign bile duct strictures. At least 1 drainage-related complication was observed in 40% of the patients. With respect to the total number of drains, prosthesis complications occurred in 23%. Occlusion, dislocation, and cholangitis were the most common complications observed during PTBD therapy. Risk factors for cholangitis and occlusion were malignant disease, prior occurrence of complications, and bilateral drainage. Proximal stenosis of the biliary system was close to significant.
  
  
  CONCLUSIONS
  Drainage-related complications are a major problem in PTBD therapy. The risk factors for occlusion and cholangitis discovered in this study can help to refine individual strategies to reduce the rate of these drainage complications.
authors.affiliation: *II. Medizinische Klinik †Institut für klinische Chemie und Pathobiochemie ‡Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Nennstiel
authors.forename: Andreas
authors.initials: A
authors.lastname: Weber
authors.forename: Günter
authors.initials: G
authors.lastname: Frick
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haller
authors.forename: Alexander
authors.initials: A
authors.lastname: Meining
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schmid
authors.forename: Bruno
authors.initials: B
authors.lastname: Neu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000628:therapy*; D002761:Cholangitis / Q000453:epidemiology / Q000209:etiology; D002779:Cholestasis / Q000628:therapy*; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000209:etiology; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult