Optimum Duration of Percutaneous Transhepatic Cholangiodrainage in Common Bile Duct Diseases Complicated by Obstructive Jaundice

Abstract

The aim: Is to determine the optimum duration of percutaneous transhepatic cholangiodrainage depending on the duration of obstructive jaundice and the baseline total bilirubin level in patients with benign and malignant common bile duct diseases complicated by obstructive jaundice. Materials and methods: The experience of applying percutaneous transhepatic cholangiodrainage was combined for 88 patients with common bile duct diseases complicated by obstructive jaundice. The patients were divided into three groups: the Group 1 included 15 patients (17.1%) with benign common bile duct diseases, the Group 2 included 11 patients (12.5%) with resectable cholangiocarcinomas, and the Group 3 included 62 patients (70.4%) with unresectable cholangiocarcinomas. To determine optimal terms of biliary decompression using percutaneous transhepatic cholangiodrainage, the Poisson process was applied, and, to be more precise, the quasi-Poisson distribution. Results: It was found that the reduction of total bilirubin was the fastest in Group 3 patients. It took these patients an average of 7-8 days to reduce total bilirubin to 50 μmole/l. In Group 1 patients, the process is somewhat slower. The duration of biliary decompression in this category of patients averages 10-12 days. For Group 2 patients, biliary decompression requires at least 12 days. Conclusions: Using the Poisson process, or, to be more precise, the quasi-Poisson distribution, we managed to determine the optimum duration of biliary decompression using percutaneous transhepatic cholangiodrainage depending on the obstructive jaundice duration and the baseline total serum bilirubin.

Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study

“…Patients are generally discharged with tubes after their condition stabilizes to reduce costs and improve hospital efficiency 7 . Patients with benign obstruction should have their tubes indwelled for at least 12 days 8 . Patients with malignant obstructive jaundice need to wear the tube until the end of their lives 4 .…”

“… 7 Patients with benign obstruction should have their tubes indwelled for at least 12 days. 8 Patients with malignant obstructive jaundice need to wear the tube until the end of their lives. 4 Some studies have found that PTBD patients with catheters are prone to complications such as catheter displacement, bleeding and bile leakage after surgery, and the rate of unplanned readmission within 30 days due to drainage tube dysfunction is as high as 63.9%.…”