Bleeding after Ultrasound-Guided Percutaneous Transhepatic Biliary Drainage in Patients with Coagulopathy: A Single Center Experience

Abstract

Background To compare the rate of bleeding for ultrasound-guided Percutaneous Transhepatic Biliary Drainage (PTBD) in patients with coagulopathy to that in patients with normal coagulation. Methods This retrospective study included a total of 837 patients who underwent PTBDs from January 2016 to December 2017. The latest coagulation parameters before PTBD were acquired in all patients. The incidence of PTBD-related bleeding was determined, and the association between bleeding and coagulopathy was evaluated. Coagulopathy referred to elevated INR (International Normalized Ratio, > 1.5) or thrombocytopenia (Platelet or PLT < 50×109/L). In this study, highest value of INR was 3.67 and lowest value of PLT was 31×109/L. Results Overall, 32of 837 patients (3.8%) experienced bleeding, 28 (3.3%) for mild bleeding and 4 (0.5%) for severe bleeding. Incidence of bleeding in patients with abnormal PLT and INR values wasn’t significantly different from those in patients with normal PLT (p = 0.769) and INR (p = 0.511). No bleeding was detected in patients with thrombocytopenia. Three cases of mild bleeding were observed in patients with INR > 1.5 (n = 60), no severe bleeding was detected. Impaired coagulopathy function was not found in patients with severe bleeding. Age (p = 0.152), gender (p = 0.094) and underlying diseases (p = 0.318) didn’t correlate significantly with the incidence or severity of PTBD-related bleeding. Conclusions In our study, patients with thrombocytopenia (30×109/L < PLT < 50×109/L) or increased INR (> 1.5) didn’t suffer from higher incidence of or more severe bleeding after PTBD.