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Journal of Ultrasound

, Volume 22, Issue 4, pp 437–445 | Cite as

Safety and effectiveness of ultrasound-guided percutaneous transhepatic biliary drainage: a multicenter experience

  • Francesco GiurazzaEmail author
  • Fabio Corvino
  • Andrea Contegiacomo
  • Paolo Marra
  • Nicola Maria Lucarelli
  • Marco Calandri
  • Mattia Silvestre
  • Antonio Corvino
  • Pierleone Lucatelli
  • Francesco De Cobelli
  • Raffaella Niola
  • Maurizio Cariati
  • Italian College of Interventional Radiology (ICIR) Rising Stars Group
Original Paper

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.

Graphic abstract

Keywords

Biliary drainage Percutaneous Ultrasound Complications Radiation dose 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual patients included in the study.

Human and animal and rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2019

Authors and Affiliations

  • Francesco Giurazza
    • 1
    Email author
  • Fabio Corvino
    • 1
  • Andrea Contegiacomo
    • 2
  • Paolo Marra
    • 3
  • Nicola Maria Lucarelli
    • 4
  • Marco Calandri
    • 5
  • Mattia Silvestre
    • 1
  • Antonio Corvino
    • 6
  • Pierleone Lucatelli
    • 7
  • Francesco De Cobelli
    • 3
  • Raffaella Niola
    • 1
  • Maurizio Cariati
    • 8
  • Italian College of Interventional Radiology (ICIR) Rising Stars Group
  1. 1.Vascular and Interventional Radiology DepartmentCardarelli HospitalNaplesItaly
  2. 2.Fondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
  3. 3.Radiology DepartmentIRCCS Ospedale San Raffaele e Università Vita-SaluteMilanItaly
  4. 4.Interdisciplinary Department of Medicine – Section of Diagnostic ImagingAldo Moro University of Bari Medical SchoolBariItaly
  5. 5.Diagnostic and Interventional Radiology Unit, Oncology DepartmentTurin UniversityTurinItaly
  6. 6.Motor Science and Wellness DepartmentUniversity of Naples “Parthenope”NaplesItaly
  7. 7.Interventional Radiology UnitDepartment of Radiological, Oncological and Anatomopathological SciencesRomeItaly
  8. 8.Diagnostic-Therapeutic Advanced Technology DepartmentASST Santi Paolo e CarloMilanItaly

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