Comparing Outcomes of Percutaneous Biliary Drainage Catheters in Right Versus Left Hepatic Approaches

Sunday, March 5, 2023

3:18 PM – 3:27 PM

Location: Phoenix Convention Center, 225AB

Presenting Author(s)

Brent J. Smith, Jr., Resident, MD

ESIR resident, PGY-5
University of Kansas Health System

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

AR

Aaron Rohr, MD

Assistant Professor
University of Kansas Medical Center
AA

Alexander Alsup, n/a

Statistician
University of Kansas Medical Center
BJ

Braden Johnson, n/a

Medical Student
University of Kansas Medical Center
XM

Xena Moore, n/a

Medical Student
University of Kansas Medical Center
DP

Daniel Pankratz, n/a

Medical Student
University of Kansas Medical Center
CW

Carissa Walter, MPH

Research Manager
University of Kansas Medical Center

Disclosure(s):

Brent J. Smith, Resident, MD, Jr.: No financial relationships to disclose

Purpose: Determine if there is a difference in complications associated with right or left hepatic percutaneous biliary drain placement in patients with benign or malignant biliary etiology.

Materials and Methods: This retrospective study included patients with benign or malignant biliary stricture and treated with percutaneous biliary drainage at a single institution from 7/28/2004 – 3/30/2021. Three hundred fifty-seven patients met inclusion criteria, seventy-seven on the left and two hundred and eighty on the right, with a mean age of 65.1 years. Complications associated with the initial drain placement or during subsequent intervention were collected and categorized. P</span>erioperative complications included surgery, infection, hemorrhage, and drain failure. Complications during treatment with a percutaneous biliary drain included death, chills, catheter displacement, cholangitis, biliary stones, drain malfunction, fever resolving without treatment, and pericatheter leakage. Complications were also grouped as major or minor. Statistical analyses were performed using Logistic Regression Analysis and p-values less than 0.05 were considered significant.

Results: Major interventional and treatment complication rates showed no statistical significance between left and right drains. The rate of minor interventional and treatment complications also showed no statistical significance between right and left drains. However, when cholangitis was analyzed individually, right sided hepatobiliary drains demonstrated a statistically significant increase in complication rates.

Conclusion: Current literature describes safety of right biliary drain placement when compared to left, despite current equivocal study analyses {1, 2, 3}. This large group analysis describes no statistically significant difference in complications between right and left hepatobiliary drains aside from slightly higher incidence of cholangitis for right sided drains.