Outcomes of percutaneous transhepatic gallbladder drainage versus percutaneous transhepatic biliary drainage for obstructive jaundice

Abstract

Percutaneous transhepatic gallbladder drainage (PTGBD) is an alternative to percutaneous transhepatic biliary drainage (PTBD) for cases of obstructive jaundice in which the bile duct obstruction is below the confluence of the cystic ducts. The present study aimed to evaluate the usefulness of PTGBD and PTBD in patients with obstructive jaundice. This study enrolled patients who had undergone percutaneous biliary drainage for acute cholangitis and obstructive jaundice at two institutions between January 2017 and March 2024. Fifty-five patients were included in this analysis. However, patients with intrahepatic or hilar bile duct stenosis, post choledocholithiasis, complex cholecystitis, total bilirubin levels < 2.0 mg/dL, and uncorrectable bleeding tendency and those who had undergone the procedure and later discontinued without puncture were excluded. The technical success rates, clinical success rates, and complication rates of the procedure were evaluated. The technical success rates were 96.3% (26/27) in the PTGBD group and 82.1% (13/28) in the PTBD group. The clinical success rates were 85.2% (23/27) in the PTGBD group and 67.9% (19/28) in the PTBD group. The complication rates were 11.1% (3/27) in the PTGBD group and 17.9% (5/28) in the PTBD group. Hence, the two groups did not significantly differ in any of the endpoints. The outcomes of PTGBD were comparable to those of PTBD in patients with obstructive jaundice. Hence, PTGBD is a reasonable treatment option for cases of obstructive jaundice in which PTBD is not feasible.