Outcome of percutaneous transhepatic biliary drainage: a retrospective study at tertiary care referral centre

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Abstract
Background: Percutaneous transhepatic biliary drainage (PTBD) effectively alleviates obstructive jaundice in benign and malignant pancreaticobiliary diseases but is associated with significant morbidity and mortality. Methods: This retrospective study analysed patients who underwent PTBD for obstructive jaundice at a tertiary care centre in southern India between January 2019 and December 2022. Data on demographics, clinical history, diagnoses, procedural details, and outcomes were collected from medical records (MRD), laboratory reports (HIS), and imaging archives (PACS). Result: Out of 148 patients who underwent PTBD from 2019 to 2022, data from 128 patients could be obtained and analysed. Most patients were male (60%) with an average age of 56, and the majority had malignant biliary obstructions, predominantly hilar cholangiocarcinoma (35%) and gall bladder carcinoma (28%). PTBD was considered successful in 80%, marked by a minimum 25% reduction in bilirubin within 2 weeks. Left-sided duct cannulation was the most common; a minority required bilateral drainage. Morbidities included peri-tubal pain (35.84%) and catheter blockage (20.75%). Kaplan–Meier curve revealed higher mortality in the initial days following PTBD. Mortality was significantly higher in patients presenting with cholangitis. Conclusions: This study emphasises the utility of PTBD as a viable intervention for patients with obstructive jaundice, especially when ERCP is not an option. The procedure effectively reduces bilirubin and allows for surgical or chemotherapy preparation in most patients. However, complications such as cholangitis and catheter-related issues remain concerns that warrant meticulous procedural technique and careful patient follow-up.

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