Usefulness of a Biliary Manipulation Catheter in Percutaneous Transhepatic Biliary Drainage

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate usefulness of a manipulation catheter in percutaneous transhepatic biliary drainage (PTBD).
Materials and Methods: A biliary manipulation catheter was used for the aspiration of retained bile and lesion crossing during an initial PTBD in 91 consecutive patients over a 6 month period. This catheter allowed for a 0.035 inch guide wire made of 5F short steel braided polyurethane. The terminal 1 cm segment was tapered and 45。angulated.
Two side holes were made in the terminal segment to facilitate the aspiration of bile. The safety of this procedure was evaluated based on whether the catheters caused complications during insertion and manipulation, and whether cholangitis was aggravated after the procedure. Effectiveness of the procedure was evaluated based on the ability to aspirate retained bile and to cross the lesion.
Results: Both the insertion of a 0.035 inch hydrophilic guide wire and aspiration of sufficient retained bile were successful with the catheter. Crossing the common bile duct (CBD) lesion had a 98.1% success rate during the initial PTBD. Crossing the hilar obstruction lesion was had a 94.7% success rate to the CBD and 92.1% to the contralateral lobe. Cholangitis improved in 97% of cases, and aggravated transiently in only 3% of cases after PTBD.
Conclusion: A biliary manipulation catheter should be considered as a useful tool for a safe and effective PTBD, attributed to the facilitation of bile aspiration and lesion crossing.

참고문헌 (Reference)

1 Harbin WP, "Transhepatic cholangiography: complications and use patterns of the fine-needle technique: a multi-insitutional survey" 135 : 15-22, 1980

2 Sacks-Berg A, "Sepsis associated with transhepatic cholangiography" 20 : 43-50, 1992

3 Gibson RN, "Percutaneous transhepatic cholangiography and biliary drainage. In Practical interventional radiology of the hepatobiliary system and gastrointestinal tract" Edward Arnold 13-31, 1994

4 Venbrux AC, "Percutaneous management of benign biliary strictures" 13 : 207-214, 1996

5 Van Delden OM, "Percutaneous drainage and stenting for palliation of malignant bile duct obstruction" 18 : 448-456, 2008

6 Gunther RW, "Percuntaneous transhepatic biliary drainage. Experience with 311 procedures" 11 : 65-71, 1988

7 Venbrux AC, "Malignant obstruction of the hepatobiliary system. In Abram’s angiography interventional radiology. 2nd ed" Lippincort Williams & Wilkins 553-559, 2006

8 Garcia-Vila JH, "Endoluminal biopsy of the bile duct with a biliary manipulation catheter" 10 : 1394-1396, 1999

9 Wada K, "Diagnostic criteria and severity assessment of acute cholangitis: Tokyo guidelines" 14 : 52-58, 2007

10 Clark CD, "Bloodstream infections after interventional procedures in the biliary tract" 191 : 495-499, 1994

11 Yedlicka JW, "Biliary tract intervention. In Interventional radiology. 3rd ed" Williams & Wilkins 1439-1608, 1997

12 Lameris JS, "Biliary drainage by ultrasoundguided puncture of the left hepatic duct" 36 : 269-274, 1985

13 Gordon RL, "Benigh biliary obstruction. In Abram’s angiography interventional radiology. 2nd ed" Lippincort Williams & Wilkins 536-552, 2006