Clinical Risk Factors for Complications in Patients Undergoing Percutaneous Transhepatic Cholangioscopy
10.15279/kpba.2020.25.1.55
- Author:
Sung Yong HAN
1
;
Tae Wook KIM
;
Dong Uk KIM
;
Young Joo PARK
;
Moon Won LEE
;
Suk KIM
;
Dong Hoon BAEK
;
Gwang Ha KIM
;
Geun Am SONG
Author Information
1. Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- Publication Type:Original Article
- From:Korean Journal of Pancreas and Biliary Tract
2020;25(1):55-63
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Background:/Aim: Percutaneous transhepatic cholangioscopy (PTCS) has been widely used for the diagnosis and treatment. PTCS-related complications (hemobilia, cholangitis, biliary tract perforations) are not infrequent. However, data on the risk factors for PTCS-related complications are limited. Therefore, we aimed to identify the risk factors for PTCS-related complications.
Methods:Two hundred thirty-three patients who underwent PTCS at a single tertiary center between January 2006 and October 2014 were enrolled. After retrospectively analyzing the patients’ medical records, 212 patients were enrolled and classified into two groups: 1) a complication group and 2) a non-complication group.
Results:The study population comprised 112 men and 100 women, with a median age of 64.5 years. Of the 212 patients, 32 (15.1%) developed complications: 14 (6.7%) developed cholangitis, six (2.8%) developed bile duct injury, and two (0.9%) developed hemobilia. In the univariate analyses, older age, a small number of tract dilatation sessions, and computed tomography (CT) findings of liver cirrhosis and a non-dilated intrahepatic duct were risk factors for PTCS-related complications. In the multivariate analysis, older age, a small number of tract dilatation sessions, and the CT finding of a non-dilated intrahepatic duct were independent factors for predicting PTCS-related complications. Serial tract dilatations (≥2 sessions) were performed in 95 patients (44.8%), but this did not affect the complication rate. In this subgroup of patients, a short interval between sessions (≤3 days) was associated with PTCSrelated complications.
Conclusions:Elderly patients and those with non-dilated intrahepatic ducts on CT need to be managed carefully. Stepwise tract dilatations and a long interval between sessions (>3 days) can help decrease PTCS-related complications.
