PDF | https://doi.org/10.46613/congastro2023-191
This work is licensed under CC BY 4.0
Uribe J1, Latorre G1, Jaramillo M1, Martinez F1, Mariné M1, Acuña P1, Silva F1, Bustamante M1, Diaz P2, Richter H2, Espino A1, Aguero C2, Sandoval F3, Meneses L2, Vargas J1
1Pontificia Universidad Católica de Chile, Santiago, Chile
2Hospital Clínico UC-CHRISTUS, Santiago, Chile
3Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile
Background: Biliary duct (BD) obstruction poses a significant clinical challenge. Most can be treated endoscopically by ERCP, but some require alternative techniques to achieve effective biliary drainage. Percutaneous trans-hepatic biliary drainage (PTBD) and endoscopic-percutaneous single-session rendezvous (EPRV) have been used as alternative techniques. There are limited evidence comparing the efficacy and safety of these techniques in patients with biliary tract obstruction.
Aim: To compare the efficacy and safety of BD drainage via PTBD as compared to EPRV.
Methods: Retrospective cohort study of patients with complex BD obstruction who underwent BD drainage procedures between 2018-2023 in Hospital Clínico UC-Christus analyzed according to whether PTBD or EPRV was performed. Clinical, laboratory and imaging data, technical and clinical success, adverse events for the analysis.
Results: 85 patients were included (47% female, mean age 61 years old), 72.9% (n=62) underwent PTBD and 27.1% (n=23) received EPRV for BD drainage. The most common cause of biliary obstruction was biliary neoplasia (54%) Baseline patient´s characteristics, technique efficacy and complications are detailed in Table 1. Technical success for BD drainage was higher in patients with PTBD as compared to EPRV (100% vs 91.3%, p=0.019), however there was no difference in clinical success between the two methods (88.7% vs 87%, p=0.824). Sepsis after the procedure was more frequent in patients with PTBD (19.4% vs 0%, p=0.023).
Conclusion: PTBD and EPRV has similar technical and clinical success in the management of patients with complex BD obstruction. Patients with PTBD had higher frequency of sepsis after the procedure. Our results suggest that the EPRV approach should be prefer, when possible, according to biliary anatomy, patients’ characteristics and expertise, due to less rate of adverse events.
