Lois J F, Gomes A S, Grace P A, Deutsch L S, Pitt H A
AJR Am J Roentgenol. 1987 Feb;148(2):367-71. doi: 10.2214/ajr.148.2.367.
Percutaneous transhepatic biliary drainage (PTD) has been advocated as a method of achieving biliary decompression in patients with cholangitis. However, the risk of PTD in these patients has not been determined. Therefore, we reviewed the records of 95 consecutive PTD patients, 30 (32%) of whom had cholangitis. Forty-four (46%) of the 95 patients underwent PTD as a preoperative measure; the remaining 51 (54%) had PTD for palliation of end-stage malignancies. Thirty-day mortality and overall morbidity were 17% and 30%, respectively, in the patients with cholangitis and 15% and 28% in the patients without cholangitis. These differences were not statistically significant. However, patients with cholangitis had a significantly higher (p less than .05) incidence of post-PTD bacteremia. In patients undergoing PTD for palliation, both mortality (25%, p less than .01) and morbidity (35%) were higher than in those being drained preoperatively. This analysis suggests that PTD can be performed safely in patients with cholangitis and that the patient's underlying disease process is more important than the presence of cholangitis in determining the outcome.
经皮经肝胆道引流术（PTD）已被倡导作为一种实现胆管炎患者胆道减压的方法。然而，这些患者接受PTD的风险尚未确定。因此，我们回顾了95例连续接受PTD患者的记录，其中30例（32%）患有胆管炎。95例患者中有44例（46%）接受PTD作为术前措施；其余51例（54%）接受PTD用于缓解终末期恶性肿瘤。胆管炎患者的30天死亡率和总体发病率分别为17%和30%，无胆管炎患者分别为15%和28%。这些差异无统计学意义。然而，胆管炎患者PTD后菌血症的发生率显著更高（p小于0.05）。在接受PTD以缓解症状的患者中，死亡率（25%，p小于0.01）和发病率（35%）均高于术前引流的患者。该分析表明，胆管炎患者可安全地进行PTD，并且在决定结果方面，患者的基础疾病进程比胆管炎的存在更为重要。
