Duration of biliary decompression in patients with common bile duct diseases complicated by obstructive jaundice using antegrade endobiliary interventions

Abstract

Introduction: Both benign and malignant diseases of common bile ducts (CBD) become the reason of obstruction. The aim of the study was to determine the optimal duration of percutaneous transhepatic cholangiodrainage (PTCD) depending on the duration of obstructive jaundice (OJ) and the initial level of total serum bilirubin. Methods: The experience of using PTCD in 88 patients with diseases of CBD complicated by OJ for the period 2011-2017 were divided into three groups: the first (1) -15 (17.1%) patients with benign diseases of CBD, the second (2) -11 (12.5%) patients with resectable cholangiocarcinomas, and the third (3) -62, 4%) patients with unresectable cholangiocarcinomas. Causes of OJ: choledocholithiasis in 6 (6.8%), strictures of CBD in 2 (2.3%) and cholangiocarcinomas of different localization in 73 (82.9%) patients. The optimal timing of biliary decompression was determined by PTCD, the Poisson process (poisson) was used, and more precisely as the quasipoisson distribution (quasipoisson), which reflects the process of reducing total serum bilirubin. Results: It was determined that the fastest decrease in total bilirubin occurs in patients of group 3, enough 7-8 days to reduce total bilirubin to 50 μmol/L. In patients of group 1, the duration of biliary decompression is 10-12 days. For patients in group 2, biliary decompression requires at least 12. Conclusions: Using the Poisson process (poisson), or more precisely the quasi-Poisson distribution (quasipoisson), it was possible to determine the optimal duration of biliary decompression by PTCD depending on the duration of OJ and the initial level of total serum bilirubin.