Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Department of Medical Physics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Abdom Radiol (NY). 2021 Feb;46(2):768-775. doi: 10.1007/s00261-020-02651-y. Epub 2020 Jul 22.
To compare the technical difficulty, safety, radiation exposure and success rates between right-sided and left-sided percutaneous transhepatic biliary drainage (RPTBD and LPTBD) in patients with malignant biliary obstruction (MBO).
Fifty patients (28 males, 22 females; mean age 51.78 years) with MBO were randomized to undergo either RPTBD or LPTBD during the study period between June 2016 and May 2018. The procedure time, fluoroscopy time, radiation doses to the operators and patients, technical success, clinical success, complications and effect on quality of life were evaluated and compared between the two groups.
Twenty-five patients were included in each group. The technical success was 100% in both groups. There was no significant difference between RPTBD and LPTBD groups in terms of major complications [4% and 12%, respectively; p = 0.297] and minor complications [40% and 32%, respectively; p = 0.597]. Further, the average procedure time (37.80 ± 13.07 min vs 41.04 ± 14.94 min), fluoroscopy time (5.88 ± 4.2 min vs 5.97 ± 3.8 min), radiation doses to the operator (136.84 ± 106.67 μSv vs 130.40 ± 106.46 μSv) and to the patient (8.23 ± 5.80 Gycm vs 11.74 ± 11.28 Gycm) were not significantly different between the groups. Clinical success was achieved in 21 patients (84%) of RPTBD group and 17 patients (68%) of LPTBD group with no significant difference (p = 0.416) between them.
There was no significant difference between RPTBD and LPTBD with reference to the technique, safety, radiation dose, success rates and impact on quality of life suggesting no laterality advantage for biliary drainage in cases of MBO.
比较右侧经皮经肝胆道引流术（RPTBD）与左侧经皮经肝胆道引流术（LPTBD）治疗恶性胆道梗阻（MBO）患者的技术难度、安全性、辐射暴露和成功率。
本研究纳入了 2016 年 6 月至 2018 年 5 月期间的 50 例 MBO 患者（男 28 例，女 22 例；平均年龄 51.78 岁），并将其随机分为 RPTBD 组和 LPTBD 组。评估并比较两组患者的手术时间、透视时间、术者和患者的辐射剂量、技术成功率、临床成功率、并发症及对生活质量的影响。
两组患者各 25 例，技术成功率均为 100%。RPTBD 组和 LPTBD 组主要并发症发生率[分别为 4%（1 例）和 12%（3 例）；p=0.297]和次要并发症发生率[分别为 40%（10 例）和 32%（8 例）；p=0.597]差异均无统计学意义。进一步，RPTBD 组的平均手术时间[（37.80±13.07）min 比（41.04±14.94）min]、透视时间[（5.88±4.2）min 比（5.97±3.8）min]、术者辐射剂量[（136.84±106.67）μSv 比（130.40±106.46）μSv]和患者辐射剂量[（8.23±5.80）Gycm 比（11.74±11.28）Gycm]差异均无统计学意义。RPTBD 组临床成功率为 84%（21 例），LPTBD 组为 68%（17 例），两组间差异无统计学意义（p=0.416）。
RPTBD 与 LPTBD 治疗 MBO 的技术、安全性、辐射剂量、成功率和对生活质量的影响无显著差异，提示在 MBO 患者中，胆道引流术无侧别优势。
