J Korean Soc Radiol.  2023 Nov;84(6):1350-1360. 10.3348/jksr.2023.0063.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction

• Yu HJ
• Park JG
• Jung GS
• Seo KI
• Park HJ
• Yun JH

• KMID: 2548564
• DOI: http://doi.org/10.3348/jksr.2023.0063

Abstract

Purpose
To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction.
Materials and Methods
This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated.
Results
During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1–233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131–2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080–2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005–1.026, p = 0.005), and incomplete closedloop pigtail formation (OR: 1.672, 95% CI: 1.098–2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter.
Conclusion
Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Keyword

Biliary Tract Cancer; Catheter; Drainage; Jaundice, Obstructive