Venkatanarasimha Nanda, Damodharan Karthikeyan, Gogna Apoorva, Leong Sum, Too Chow Wei, Patel Ankur, Tay Kiang Hiong, Tan Bien Soo, Lo Richard, Irani Farah
From the Interventional Radiology Center, Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore.
Radiographics. 2017 Mar-Apr;37(2):665-680. doi: 10.1148/rg.2017160159.
Complications related to percutaneous biliary tract interventions (PBTIs) can range from access site discomfort to life-threatening vascular complications. These complications are relatively uncommon, and most of them are self-limiting. However, major complications for which an increased level of patient care and/or a prolonged hospital stay are required and that may lead to death-albeit rarely-can occur. Some of the most common complications related to PBTI include pain, infection, bile leakage, and catheter blockage. These conditions can be easily recognized by using the patient's clinical history and laboratory examination results. However, the more uncommon complications, such as life-threatening hemobilia, acute pancreatitis, and catheter and stent fractures, may have nonspecific clinical manifestations, and the underlying pathologic condition may be found only when it is being sought specifically. It is important that diagnostic and interventional radiologists be aware of the wide spectrum of PBTI-related complications, as early recognition and treatment may prevent catastrophic situations. In addition, knowledge of the different treatment options is essential for guidance in interventional radiology procedures such as transarterial control of hemobilia, imaging-guided direct percutaneous embolization of pseudoaneurysms, and percutaneous treatment of catheter- and stent-related complications such as fractures. The authors review a wide spectrum of complications associated with PBTI and the percutaneous management of these conditions. They also highlight valuable lessons learned from morbidity and mortality rounds at a high-volume tertiary care center. RSNA, 2017.
经皮胆道介入治疗（PBTIs）相关并发症的范围从穿刺部位不适到危及生命的血管并发症。这些并发症相对少见，且大多数为自限性。然而，可能需要加强患者护理水平和/或延长住院时间且可能导致死亡（尽管很少见）的严重并发症也可能发生。一些与PBTI相关的最常见并发症包括疼痛、感染、胆漏和导管堵塞。通过患者的临床病史和实验室检查结果可以很容易地识别这些情况。然而，一些较罕见的并发症，如危及生命的胆道出血、急性胰腺炎以及导管和支架断裂，可能具有非特异性临床表现，只有在专门寻找时才可能发现潜在的病理状况。诊断和介入放射科医生了解PBTI相关并发症的广泛范围很重要，因为早期识别和治疗可能预防灾难性情况。此外，了解不同的治疗选择对于指导介入放射学操作至关重要，如经动脉控制胆道出血、影像引导下直接经皮栓塞假性动脉瘤以及经皮治疗导管和支架相关并发症（如断裂）。作者回顾了与PBTI相关的广泛并发症以及这些情况的经皮处理方法。他们还强调了在一家大型三级医疗中心的发病率和死亡率讨论中吸取的宝贵经验教训。RSNA，2017年。
