Safety of percutaneous transhepatic biliary stenting in patients with obstructive jaundice

Objective: To determine the safety of percutaneous transhepatic biliary stenting (PTBS) in patients with obstructive jaundice. Study Design: A case series. Place and Duration of Study: Department of Radiology, The Aga Khan University Hospital Karachi, Pakistan, from February 2012 to April 2013. Methodology: Patients with obstructive jaundice due to any cause referred for percutaneous transhepatic biliary stenting were included in the study. Patients were excluded if they had undergone previous ERCP, had guided transhepatic biliary stenting, previous percutaneous transhepatic biliary stenting and were lost to follow-up. Follow-up was taken at a 2, 4 and 6 week interval and clinical outcome was assessed as the difference between the bilirubin levels at base line and 6 weeks after PTBS, which was measured using Freidman's test. Results: A total of 102 patients were included; 59 (58%) were males and 43 (42%) were females. The age ranged from 21 to 89 years. A total of 30 patients experienced complications making an overall complication rate of 29.4%; 20 experienced minor and 10 experienced major complications. Pain was the most frequent minor complication (n=15 patients, 14.7%) followed by biliary leakage, fever and cholangitis. Major complications included death in 10 (10%) patients followed by biliary peritonitis and septicemia. Conclusion: PTBS achieved satisfactory palliation with a low complication rate in patients with obstructive jaundice.