ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction

Fairchild, Alexandra H.; Hohenwalter, Eric J.; Gipson, Matthew G.; Al‐Refaie, Waddah B.; Braun, Aaron R; Cash, Brooks D.; Kim, Charles Y.; Pinchot, Jason W.; Scheidt, Matthew J.; Schramm, Kristofer; Sella, David M.; Weiss, Clifford R.; Lorenz, Jonathan M.

doi:10.1016/j.jacr.2019.02.020

Cited by 13 publications

(9 citation statements)

References 132 publications

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“…The American College of Radiology appropriateness criteria [25] states internal-external catheter as 'usually appropriate' and permanent biliary metallic stent as 'may be appropriate' for MBTO including CBD or hilar level blocks. Other workers have also found better survival with stents, even with hilar obstructions, e.g., in the study of Shim et al, median survival was 212 days [22].…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of percutaneous transhepatic biliary drainage for malignant biliary tract obstruction—a prospective study comparing external and internal drainage techniques

et al. 2021

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Purpose To evaluate the clinical results of percutaneous transhepatic biliary drainage (PTBD) in patients with non-operable malignant biliary tract obstruction (MBTO) and the survival benefit of internal drainage. Methods Prospective data of consecutive patients of PTBD from May 2014 to August 2017 was analyzed for 30-day, 90-day and 1-year mortality, and mean survival of patients undergoing external drainage (ED) and internal drainage (ID) using internal-external ring biliary catheterization or biliary stent were compared. Other important variables evaluated were drop in the total bilirubin (TBil) levels, improvement in pain and pruritus, procedure-related complications, and patient satisfaction. Results In 87 cases (54 male, 33 female) with mean age 37.3 y (22-70 y; 95% CI: 31.1 y-43.5 y), 10, 45 and 32 patients underwent stenting, external and internal-external catheterization, respectively (total 152 procedures [> 1 in 35.63%, n = 31]). PTBD resulted in decrease in mean TBil by 8.2738 ± 0.912 mg/dL at 30 days (P < 0.001), 55.14% (n = 48) cases reaching 3 mg/dL at mean 45 days, and 35/48 cases received chemotherapy. Overall mortality was 6.89%, 37.93% and 90.80% at 30 days, 90 days and 1 year, respectively. Mean survival with ID (236.40 ± 33.37 days) was better than with ED (110.35 ± 26.16 days) (P < 0.001). Pain (62.06%; n = 54; mean Visual Analog Scale [VAS] score = 6.7) improved significantly (mean VAS score 3.4; P < 0.001). Pruritus (n = 29) was relieved in 100% of the cases. Complication rate of 18.39% (n = 16) and no procedure-related death were seen. Conclusion PTBD offers a safe and significant improvement in TBil, pain, and pruritus in non-operable MBTO, with ID offering additional survival benefit over ED.

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Section: Discussionmentioning

confidence: 99%

Survival benefit of percutaneous transhepatic biliary drainage for malignant biliary tract obstruction—a prospective study comparing external and internal drainage techniques

et al. 2021

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“…Como se abordó con anterioridad, esta patología normalmente es consecuencia de una colelitiasis previa. La obstrucción biliar aguda provocada por la colédocolitiasis es considerada una emergencia, ya que pone en peligro la vida del individuo y por esta razón es que, en la mayoría de los casos, la descompresión de la vía biliar posterior a la estabilización del paciente es el tratamiento definitivo, pues si no se trata la patología aun en casos asintomáticos, existe la posibilidad de desarrollar complicaciones como pancreatitis aguda o colangitis (20). No obstante, dicho tratamiento va a depender del grado de sospecha clínica de colédocolitiasis que tenga el paciente.…”

Section: Coledocolitiasisunclassified

Enfermedades De La Vesícula y Vías Biliares: Actualidad.

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et al. 2022

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Las enfermedades de la vesícula y vía biliar constituyen, en la actualidad, varias de las patologías de manejo médico-quirúrgico más comunes a nivel mundial. Su etiopatogenia, en general, ha sido relacionada principalmente con desórdenes de tipo metabólico asociados a defectos en la secreción de lípidos biliares (así como con la sobresaturación biliar de colesterol y la precipitación de cristales conformados por esta última sustancia u otras como bilirrubina o calcio en muchas ocasiones). Es debido a todos estos motivos (así como a su frecuencia relativamente elevada entre la población) que se plantea la siguiente investigación, esto puesto que con el paso de los años son mayores y más profundos los conocimientos que se han ido adquiriendo no solo acerca de la clínica y del diagnóstico de todo este espectro de condiciones clínicas, sino que también de los tratamientos que se consideran como los más adecuados para estas y con respecto a la utilidad en pro de la mejora de los pacientes

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“…Percutaneous biliary interventions (PBIs), specifically percutaneous transhepatic cholangiography (PTC) and percutaneous biliary drainage (PBD), are common procedures performed for diagnosis and treatment of various hepatobiliary disorders [1,2]. PBI is indicated for the management of common bile duct and intrahepatic bile duct obstruction from malignant and nonmalignant etiologies.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to their diagnostic utility, PBI also allows for a plethora of therapeutic interventions that include draining infected bile secondary to cholangitis, dilating or stenting biliary strictures, and removing biliary stones [1,5,7]. Though endoscopic retrograde cholangiopancreatography (ERCP) and MR cholangiopancreatography are used to diagnose and treat many of the same biliary pathologies, a percutaneous approach with PTC or PBD remains an attractive option, especially when ERCP has failed or is not feasible (eg, in patients with gastrojejunostomy, or inability to cannulate the sphincter of Oddi) [5,7,8].…”

Section: Introductionmentioning

confidence: 99%