Nennstiel Simon, Weber Andreas, Frick Günter, Haller Bernhard, Meining Alexander, Schmid Roland M, Neu Bruno
*II. Medizinische Klinik †Institut für klinische Chemie und Pathobiochemie ‡Institut für Medizinische Statistik und Epidemiologie, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
J Clin Gastroenterol. 2015 Oct;49(9):764-70. doi: 10.1097/MCG.0000000000000275.
Procedure-related complications of percutaneous transhepatic biliary drainage (PTBD) have been well documented in the literature. However, relatively restricted data are available concerning drainage-related complication rates in long-term PTBD therapy. The present retrospective study evaluated the extent and the nature of drainage complications during PTBD therapy and associated risk factors for these complications.
Between June 1997 and May 2007, a total of 385 patients with PTBD were identified by analyzing the PTBD database and hospital charts, with a total of 2468 percutaneous biliary drainages being identified.
Among the identified patients, 243 (63%) had malignant and 142 (37%) had benign bile duct strictures. At least 1 drainage-related complication was observed in 40% of the patients. With respect to the total number of drains, prosthesis complications occurred in 23%. Occlusion, dislocation, and cholangitis were the most common complications observed during PTBD therapy. Risk factors for cholangitis and occlusion were malignant disease, prior occurrence of complications, and bilateral drainage. Proximal stenosis of the biliary system was close to significant.
Drainage-related complications are a major problem in PTBD therapy. The risk factors for occlusion and cholangitis discovered in this study can help to refine individual strategies to reduce the rate of these drainage complications.
经皮经肝胆道引流术（PTBD）的手术相关并发症在文献中已有充分记载。然而，关于长期PTBD治疗中引流相关并发症发生率的数据相对有限。本回顾性研究评估了PTBD治疗期间引流并发症的程度和性质以及这些并发症的相关危险因素。
通过分析PTBD数据库和医院病历，在1997年6月至2007年5月期间，共识别出385例行PTBD的患者，共识别出2468次经皮胆道引流。
在识别出的患者中，243例（63%）患有恶性疾病，142例（37%）患有良性胆管狭窄。40%的患者至少观察到1种引流相关并发症。就引流总数而言，假体并发症发生率为23%。阻塞、移位和胆管炎是PTBD治疗期间观察到的最常见并发症。胆管炎和阻塞的危险因素为恶性疾病、既往并发症发生情况和双侧引流。胆道系统近端狭窄接近显著水平。
引流相关并发症是PTBD治疗中的一个主要问题。本研究中发现的阻塞和胆管炎的危险因素有助于完善个体策略以降低这些引流并发症的发生率。
