Percutaneous biliary drainage effectively lowers serum bilirubin to permit chemotherapy treatment

Levy, Jack; Sudheendra, Deepak; Dagli, Mandeep; Mondschein, Jeffrey I.; Stavropoulos, S. William; Shlansky-Goldberg, Richard D.; Trerotola, Scott O.; Teitelbaum, Ursina R.; Soulen, Michael C.

doi:10.1007/s00261-015-0580-z

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…The main goal of palliative care is to reduce the manifestations of jaundice, intoxication, pain syndrome and prolongation of life period [4]. A decrease in the level of serum bilirubin also improves conditions for chemotherapy [5].…”

Section: Discussionmentioning

confidence: 99%

Dynamics of the serum bilirubin level during bile ducts drainage in patients with hilar tumor stenosis and jaundice

Palytsya¹,

Markulan

Tsema

et al. 2021

J Educ Health Sport

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Palliative bile duct decompression with various modifications are currently performed in 75-80% of patients with hilar stenosis caused by the tumor. The main goal of palliative care is to reduce the manifestations of jaundice, intoxication, pain syndrome, prolong life period and improve patient's conditions for chemotherapy.Objective: to evaluate the effectiveness of bile ducts antegrade drainage methods by bilirubin reducing in the palliative treatment of patients with jaundice due to hilar stenosis caused by the tumor. Materials and methods.In a prospective study included 78 patients with hilar obstructive jaundice, who were underwent of palliative antegrade draining of bile ducts: percutaneous transhepatic cholangiostomy (group PTC) -n = 24, externally-internal suprapapillary cholangiostomy (group EISC) -n = 26, percutaneous transhepatic antegrade endobiliary stenting (group PTAES) -n = 28. Endpoints of the study: total serum bilirubin before the procedure, after 3, 7 days and every 10 days for two months. The mean values of bilirubin and the average percentage of decrease in its value at each of the control periods were evaluated in relation to the initial level. Also, at the same time, the cumulative percentage of patients in which bilirubin had a value of ≤34.2 μmol / L (2 mg / dL) or ≤ 85.5

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Section: Discussionmentioning

confidence: 99%

Dynamics of the serum bilirubin level during bile ducts drainage in patients with hilar tumor stenosis and jaundice

Palytsya¹,

Markulan

Tsema

et al. 2021

J Educ Health Sport

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“…8 Finally, initiation of many chemotherapeutic agents requires an intact bile excretion pathway to prevent toxicities. 9 Despite these theoretical advantages, preoperative biliary drainage in surgical candidates has been found to be associated with higher rates of postoperative complications, and routine preoperative decompression in surgical candidates is discouraged. 2,3,[10][11][12] If a prompt surgery-first approach is not possible or desired, then biliary decompression would be indicated for symptomatic relief and therapeutic purposes.…”

Section: Preoperative Biliary Drainage In Surgical Candidatesmentioning

confidence: 99%

Multidisciplinary Approach to Malignant Biliary Obstruction

Kim

Rahman

Tenney

et al. 2020

Digestive Disease Interventions

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Treatment of malignant biliary obstruction (MBO) requires the coordination of multiple specialties, including oncologists, surgeons, gastroenterologists, and interventional radiologists. If the tumor is resectable, surgical candidates can usually proceed to surgery without preoperative biliary drainage. For patients who undergo biliary drainage, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC) combined with biliary stenting are techniques with comparable technical success and mortality, each with distinct advantages and risks. Advances in endoscopic ultrasound allow drainage in patients with challenging anatomy. There are a multitude of devices used for biliary decompression. Self-expanding metal stents (SEMS), with longer patency rates, are in most instances preferred over plastic stents for MBO, especially in patients with life expectancy more than 3 to 4 months. Advantages of covered SEMS versus uncovered SEMS remain controversial as covered stents can prevent tumor ingrowth but at the expense of potential increase in stent migrations. Extra-anatomic biliary drainage using lumen-apposing metal stents is an emerging technique which shows promise when conventional ERCP fails. It is imperative to understand these techniques when tailoring a treatment strategy. The goal of this article is to discuss a multidisciplinary approach for MBO to promote comprehensive care using case examples to highlight essential principles.

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“…Two fellowship-trained interventional radiologists (A.S. and J.W., with 4 and 6 years of interventional radiology experience, respectively) independently reviewed the medical re- [5][6][7][8][9][10][11][12][13][14]. Among all patients who were readmitted, there were 47.5% (58 of 122; Table 3) who were admitted between 0 and 7 days and 52.4% (64 of 122) between 8 and 30 days.…”

Section: Assessment Of Cause and Preventability Of Readmissionmentioning

confidence: 99%

“…Just over half of all readmissions related to interventional radiology were deemed preventable. For example, four readmissions were because of interventional radiology care: two patients who did not have more than 75% of their hepatic segments drained, as generally recommended; and two patients with biliary leaks whose drains were capped prematurely, before resolution of the leak as generally recommended (8,12,13). Similarly, patients who presented with leakage after discharge typically had the proximal side holes of their internal-external biliary drainage catheter positioned centrally, resulting in exclusion of segmental ducts.…”

Section: Assessment Of Cause and Preventability Of Readmissionmentioning

confidence: 99%

Causes and Rates of 30-day Readmissions after Percutaneous Transhepatic Biliary Drainage Procedure

et al. 2019

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To investigate rates and causes of 30-day readmission for patients who undergo percutaneous transhepatic biliary drainage (PTBD) procedures. Materials and Methods: In this retrospective study, PTBD procedures performed at a tertiary care institution (June 2008 to May 2013) were reviewed. For each patient, the first 30-day readmission was used to determine cause of readmission. Two interventional radiologists independently categorized causes for readmission as planned or unplanned, and unplanned causes as related to or unrelated to interventional radiology. Interventional radiology-related readmissions were categorized as potentially preventable or unpreventable. Factors associated with higher odds for 30-day readmission were identified with univariable and multivariable analysis. Results: There were 266 procedures in 266 patients (mean age, 67 years; interquartile range, 57-76 years; 53.4% men). The cause of obstruction was malignant in 50.0% of patients (133 of 266). There were 122 of 266 patients (45.9%) readmitted within 30 days. Of these readmissions, 44 of 122 (36.1%) were planned and 78 of 122 (63.9%) were unplanned. A majority of unplanned readmissions (57 of 78; 73%) were related to interventional radiology. Of unplanned interventional radiology-related readmissions, 16% (nine of 57) were related to periprocedural complications and 51% (29 of 57) were considered preventable. At multivariable analysis, Medicaid insurance (odds ratio, 3.68; 95% confidence interval: 1.52, 9.99; P = .009) and bilateral PTBDs (odds ratio, 5.81; 95% confidence interval: 1.79, 18.90; P = .003) were associated with 30-day readmission. Conclusion: Thirty-day readmissions after primary biliary drainage are common and a majority of unplanned readmissions are drainrelated. Nearly half of unplanned interventional radiology-related readmissions are potentially preventable.

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Percutaneous biliary drainage effectively lowers serum bilirubin to permit chemotherapy treatment

Cited by 14 publications

References 14 publications

Dynamics of the serum bilirubin level during bile ducts drainage in patients with hilar tumor stenosis and jaundice

Dynamics of the serum bilirubin level during bile ducts drainage in patients with hilar tumor stenosis and jaundice

Multidisciplinary Approach to Malignant Biliary Obstruction

Causes and Rates of 30-day Readmissions after Percutaneous Transhepatic Biliary Drainage Procedure

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