Comparing outcomes of right verse left hepatic approach percutaneous biliary drainage catheters

IF 1.4 Q3 SURGERY Surgery open science Pub Date : 2024-05-29 DOI:10.1016/j.sopen.2024.05.014
Brent Smith MD , Jodi Veach BA , Carissa Walter MPH , Alexander Alsup MS , Kate Young PhD , Lauren Clark MS , Yanming Li PhD , Aaron Rohr MD, MS
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Abstract

Purpose

Determine if there is a difference in adverse events (AE) between right or left hepatic percutaneous biliary drain placement (PTBD) in patients with biliary strictures.

Materials & methods

This retrospective study included patients with benign or malignant biliary stricture treated with PTBD at a single institution from 7/28/2004–3/30/2021. 357 patients met inclusion criteria, 77 (21.6 %) had PTBD on the left and 280 (78.4 %) on the right. AEs associated with the initial drain placement or during subsequent intervention were collected and categorized. AEs that were grouped as periprocedural included: surgery, infection, hemorrhage, and drain failure. AEs in the postprocedural group included: chills, catheter displacement, cholangitis, biliary stones, drain malfunction, fever resolving without treatment, and pericatheter leakage. Surgery was considered a major AE and the remaining AEs were categorized as minor. Statistical analyses were performed using Logistic Regression Analysis and p-values less than 0.05 were considered statistically significant.

Results

Overall, there was no statistically significant difference in AEs between right and left drains in the periprocedural and postprocedural period (p = 0.832, OR = 0.95 and p = 0.808, OR = 0.93 respectively). When analyzing minor AEs individually, only cholangitis occurred at a higher rate on the right side (p = 0.033, OR = 0.43). There was no statistical difference in the rate of major AEs in the periprocedural period between left and right drains (p = 0.311, OR = 1.37).

Conclusion

Current literature is equivocal when comparing right versus left percutaneous biliary drains. This analysis describes no statistically significant difference in AEs between right and left hepatobiliary drains aside from slightly higher incidence of cholangitis for right sided drains.

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比较右肝和左肝途径经皮胆道引流导管的疗效
目的确定右侧或左侧肝脏经皮胆道引流管置入术(PTBD)对胆道狭窄患者的不良事件(AE)是否存在差异。材料& 方法这项回顾性研究纳入了2004年7月28日至2021年3月30日期间在一家机构接受PTBD治疗的良性或恶性胆道狭窄患者。357名患者符合纳入标准,其中77人(21.6%)在左侧接受了PTBD,280人(78.4%)在右侧接受了PTBD。收集并分类了与首次引流管置入或后续干预相关的 AEs。被归为围术期的AE包括:手术、感染、出血和引流管失效。术后AE包括:寒战、导管移位、胆管炎、胆道结石、引流管故障、未经治疗而退烧以及导管周围渗漏。手术被认为是主要的 AE,其余 AE 被归类为轻微 AE。采用逻辑回归分析法进行统计分析,P值小于0.05为有统计学意义。结果总体而言,右侧和左侧引流管在术前和术后的AEs差异无统计学意义(分别为P = 0.832,OR = 0.95和P = 0.808,OR = 0.93)。单独分析轻微意外伤害时,只有胆管炎在右侧发生率较高(p = 0.033,OR = 0.43)。在围手术期,左侧和右侧引流管的主要 AE 发生率没有统计学差异(p = 0.311,OR = 1.37)。除了右侧引流管的胆管炎发生率略高之外,本分析描述了右侧和左侧肝胆管引流管在AEs方面没有统计学意义上的显著差异。
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来源期刊
CiteScore
1.30
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0.00%
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审稿时长
66 days
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