KMID : 0985520200250010055
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Korean Journal of Pancreas and Biliary Tract 2020 Volume.25 No. 1 p.55 ~ p.63
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Clinical Risk Factors for Complications in Patients Undergoing Percutaneous Transhepatic Cholangioscopy
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Han Sung-Yong
Kim Tae-Wook Kim Dong-Uk Park Young-Joo Lee Moon-Won Kim Suk Baek Dong-Hoon Kim Gwang-Ha Song Geun-Am
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Abstract
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Background/Aim: Percutaneous transhepatic cholangioscopy (PTCS) has been widely used for the diagnosis and treatment. PTCS-related complications (hemobilia, cholangitis, biliary tract perforations) are not infrequent. However, data on the risk factors for PTCS-related complications are limited. Therefore, we aimed to identify the risk factors for PTCS-related complications.
Methods: Two hundred thirty-three patients who underwent PTCS at a single tertiary center between January 2006 and October 2014 were enrolled. After retrospectively analyzing the patients¡¯ medical records, 212 patients were enrolled and classified into two groups: 1) a complication group and 2) a non-complication group.
Results: The study population comprised 112 men and 100 women, with a median age of 64.5 years. Of the 212 patients, 32 (15.1%) developed complications: 14 (6.7%) developed cholangitis, six (2.8%) developed bile duct injury, and two (0.9%) developed hemobilia. In the univariate analyses, older age, a small number of tract dilatation sessions, and computed tomography (CT) findings of liver cirrhosis and a non-dilated intrahepatic duct were risk factors for PTCS-related complications. In the multivariate analysis, older age, a small number of tract dilatation sessions, and the CT finding of a non-dilated intrahepatic duct were independent factors for predicting PTCS-related complications. Serial tract dilatations (¡Ã2 sessions) were performed in 95 patients (44.8%), but this did not affect the complication rate. In this subgroup of patients, a short interval between sessions (¡Â3 days) was associated with PTCSrelated complications.
Conclusions: Elderly patients and those with non-dilated intrahepatic ducts on CT need to be managed carefully. Stepwise tract dilatations and a long interval between sessions (>3 days) can help decrease PTCS-related complications.
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KEYWORD
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Cholangiography, Complications, Risk factors
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