title: Reduced complication rates of percutaneous transhepatic biliary drainage with ultrasound guidance.
abstract: BACKGROUND
  We aimed to analyze the benefits of adding ultrasound (US) guidance to the standard fluoroscopically assisted percutaneous transhepatic biliary drainage (F-PTBD). We also performed a systematic literature review of success and complication rates of US-PTBD in a wide field of indications.
  
  
  METHODS
  We evaluated a total of 81 US-PTBDs carried out in our institution, 74% of which were part of the management of malignancy. In addition, we compared our results with those of a total of 5,272 procedures (3,779 F-PTBD and 1,493 US-PTBD) reported in the literature.
  
  
  RESULTS
  US-PTBD was technically successful in 94% of attempts with a mean of 2.2 needle passes. Procedural success was achieved in 86% of cases. There were no procedure-related deaths or severe complications. Minor complications were catheter dislodgement (15%) as well as one case each of a porto-biliary fistula, hematoma, and biloma. A systematic review of the literature also showed that US-PTBD has a similar technical success rate to F-PTBD but lower median rates of severe early complications (0% versus 8%) and procedural death (0% versus 1%).
  
  
  CONCLUSIONS
  Given our results and our review of the literature, US-PTBD is as effective as F-PTBD and has significantly lower complication rates. US-PTBD should be preferred to F-PTBD. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:400-407, 2017.
authors.affiliation: Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
authors.forename: Andrej
authors.identifier: http://orcid.org/0000-0003-3525-3326
authors.initials: A
authors.lastname: Wagner
authors.affiliation: Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.|Laboratory for Tumour Biology and Experimental Therapies, Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Mayr
authors.affiliation: Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.|Laboratory for Tumour Biology and Experimental Therapies, Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kiesslich
authors.affiliation: Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
authors.forename: Frieder
authors.initials: F
authors.lastname: Berr
authors.affiliation: Department of Internal Medicine, Landeskrankenhaus Muerzzuschlag, Austria.
authors.forename: Paul
authors.initials: P
authors.lastname: Friesenbichler
authors.affiliation: Department of Internal Medicine I, Paracelsus Medical University/Salzburger Landeskliniken, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
authors.forename: Gernot W
authors.initials: GW
authors.lastname: Wolkersdörfer
mesh_terms: D000368:Aged; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D001652:Bile Ducts / Q000000981:diagnostic imaging; D004322:Drainage / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: bile ducts; complications; liver; percutaneous; ultrasonography