Francesco Giurazza1, Fabio Corvino2, Andrea Contegiacomo3, Paolo Marra4, Nicola Maria Lucarelli5, Marco Calandri6, Mattia Silvestre2, Antonio Corvino7, Pierleone Lucatelli8, Francesco De Cobelli4, Raffaella Niola2, Maurizio Cariati9. 1. Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Cardarelli 9, 80100, Naples, Italy. francescogiurazza@hotmail.it. 2. Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Cardarelli 9, 80100, Naples, Italy. 3. Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00136, Rome, Italy. 4. Radiology Department, IRCCS Ospedale San Raffaele e Università Vita-Salute, Via Olgettina 60, 20132, Milan, Italy. 5. Interdisciplinary Department of Medicine - Section of Diagnostic Imaging, Aldo Moro University of Bari Medical School, Bari, Italy. 6. Diagnostic and Interventional Radiology Unit, Oncology Department, Turin University, Turin, Italy. 7. Motor Science and Wellness Department, University of Naples "Parthenope", Via F. Acton 38, 80100, Naples, Italy. 8. Interventional Radiology Unit, Department of Radiological, Oncological and Anatomopathological Sciences, Viale Regina Elena 324, 00100, Rome, Italy. 9. Diagnostic-Therapeutic Advanced Technology Department, ASST Santi Paolo e Carlo, Via Pio II 3, 20153, Milan, Italy.
Abstract
AIMS: Aim of this study is to describe a multicenter experience on percutaneous transhepatic biliary drainage (PTBD) performed with ultrasound-guidance to access the biliary tree, focusing on safety, effectiveness and radiation dose exposure; differences between right- and left-sided approaches have been also evaluated. METHODS: This is a multicenter prospective single-arm observational study conducted on patients affected by biliary tree stenosis/occlusion with jaundice and endoscopically inaccessible. The procedures have been performed puncturing the biliary system under US guidance and crossing the stenosis/occlusion under fluoroscopy. Beam-on time and X-ray dose have been evaluated. RESULTS: 117 patients affected by biliary tree stenosis/occlusion not manageable with an endoscopic approach have been included in this analysis. The biliary stenosis/occlusion was malignant in 90.8% and benign in 9.2%. Technical success, considered as positioning of a drainage tube into the biliary tree, was 100%. Overall clinical success, considered as decrease in total bilirubin level after a single procedure, was 95.7%. The overall mean number of liver punctures to catheterize the biliary tree was 1.57. The mean total beam-on time was 570.4 s; the mean dose-area product was 37.25 Gy cm2. No statistical significant differences were observed in terms of technical and dosimetry results according to right-sided and left-sided procedures. Complications rate recorded up to 30 days follow-up was 10.8%, all of minor grades. CONCLUSIONS: In this series US guidance to access the biliary tree for PTBD was a safe and effective technique with an acceptable low-grade complications rate; the reported radiation dose is low.
AIMS: Aim of this study is to describe a multicenter experience on percutaneous transhepatic biliary drainage (PTBD) performed with ultrasound-guidance to access the biliary tree, focusing on safety, effectiveness and radiation dose exposure; differences between right- and left-sided approaches have been also evaluated. METHODS: This is a multicenter prospective single-arm observational study conducted on patients affected by biliary tree stenosis/occlusion with jaundice and endoscopically inaccessible. The procedures have been performed puncturing the biliary system under US guidance and crossing the stenosis/occlusion under fluoroscopy. Beam-on time and X-ray dose have been evaluated. RESULTS: 117 patients affected by biliary tree stenosis/occlusion not manageable with an endoscopic approach have been included in this analysis. The biliary stenosis/occlusion was malignant in 90.8% and benign in 9.2%. Technical success, considered as positioning of a drainage tube into the biliary tree, was 100%. Overall clinical success, considered as decrease in total bilirubin level after a single procedure, was 95.7%. The overall mean number of liver punctures to catheterize the biliary tree was 1.57. The mean total beam-on time was 570.4 s; the mean dose-area product was 37.25 Gy cm2. No statistical significant differences were observed in terms of technical and dosimetry results according to right-sided and left-sided procedures. Complications rate recorded up to 30 days follow-up was 10.8%, all of minor grades. CONCLUSIONS: In this series US guidance to access the biliary tree for PTBD was a safe and effective technique with an acceptable low-grade complications rate; the reported radiation dose is low.
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