Arterial Complications of Percutaneous Transhepatic Biliary Drainage

Abstract

Arterial bleeding is a relatively rare complication of PTBD that can easily be treated by selective arterial embolization when it does not resolve spontaneously. In this series its frequency was much higher (16%) when the stenosis was benign than when it was malignant (0.6%).

Gastrointestinal Bleeding Secondary to Hepatic Artery Involvement of Microscopic Polyangiitis: Case Report and Review of the Literature

“…In a group of 171 patients with hemobilia, 73 [43%] required only conservative treatment [21]. In the case of continued bleeding, TAE as in our case has been shown to be successful in 80-100% of cases [27][28][29][30]. Since the reported morbidity and mortality rates of TAE are lower than for surgery, TAE should be attempted first.…”

Hepatic abscess following transhepatic drainage of subphrenic abscess

“…To our knowledge, there has not been a reported case of a liver abscess developing along the course of a transhepatic catheter. The prior reported complications of the transhepatic approach for catheter placement include hepatic-artery pseudoaneurysms, arteriovenous fistulas, hemobilia, subcapsular hematomas, and hemoperitoneum [5]. In our case, the location of the abscess immediately along the tract of the drainage catheter and the similar organisms recovered from bacteriologic culture clearly suggest that the abscess was related to direct contamination along the tract of the drainage catheter.…”

Placement of endoscopic naso-biliary drainage does not preclude subsequent percutaneous transhepatic biliary drainage

“…[1][2][3][4] Once the PTBD catheter has been safely inserted, however, this modality has many advantages. It allows PTCS, an excellent procedure for bile duct biopsy, 5-7 and lithotripsy.…”