Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction

• Published in: Journal of the Korean Society of Radiology 2023, 84(6), , pp.1350-1360
• Main Authors: Yu, Hee Jeong, Park, Jung Gu, Jung, Gyoo Sik, Seo, Kwang Il, Park, Hyun Joon, Yun, Jong Hyouk
• Format: Article
• Language: English
• Subjects: biliary tract cancer; catheter; drainage; Interventional Radiology; jaundice; obstructive; 방사선과학
• ISSN: 2951-0805; 2951-0805
• DOI: 10.3348/jksr.2023.0063

To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.