Study of Outcome and Success Rate in Percutaneous Transhepatic Biliary Stent for Malignant Biliary Obstruction in Srinagarind Hospital, Khon Kaen University
Anucha Ahooja1, Piyawat Eyosawat1, Tanita Suttichaimongkol2, Witsarut Manasirisuk2, Jarin Chindaprasirt3, Chitchai Rattananukrom2
Affiliation : 1 Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Division of Oncology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: Malignant biliary obstruction (MBO) is likely to be inoperable at first presentation. Palliative biliary drainage is essential to increase overall survival. Percutaneous transhepatic biliary stent (PTBS) is one of the most effective and safe procedure of biliary drainage in malignant biliary obstruction. However, there are no previous studies of outcome, success rate, and complications of PTBS insertion for biliary drainage of MBO in Thai population.
Objective: To determine outcome, success rate, and complications of PTBS insertion in MBO in tertiary care medical center in Thailand.
Materials and Methods: A retrospective cohort study was performed on 41 patients with MBO underwent PTBS insertion from 2015 to 2021. Technical data, success rate, and outcome data including survival analysis, occlusion rate, and complications were analyzed.
Results: Of 41 patients, PTBS insertion had technical success 82.93% and functional success 70.59%. Median survival time of patients was 95 days (95% CI 89.5 to 193). Occlusion rate occurred in only 22.6% of patients and all of them underwent percutaneous transhepatic biliary drainage (PTBD) as alternative palliative biliary drainage. Mean occlusion-free survival time was 77.14 days (95% CI 38.9 to115). Majority of patients (79.4%) did not have PTBS-related complications. The most common complication was acute cholangitis that found only in 6 patients (17.6%). Median complication-free survival was 91 days (95% CI 86.8 to 247). For the group of patients with functional success after PTBS insertion, the 30-day, 120-day, and 390-day cumulative survival rates and 30-day, 120 y, and 390-day cumulative occlusion-free survival rates were statistically significantly better than those with functional failure (p=0.030 and p=0.007).
Conclusion: Outcomes and success rate of PTBS insertion in Srinagarind Hospital were 82.93% in technical success and 70.59% in functional success. Functional success of PTBS insertion was the most important issue that related with better cumulative survival and occlusion-free survival.
Received 19 January 2024 | Revised 12 April 2024| Accepted 14 May 2024
DOI:10.35755/jmedassocthai.2024.S01.S9-S15
Keywords : Percutaneous transhepatic biliary stent (PTBS); Malignant biliary obstruction (MBO)
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