Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, whic...Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be pal iative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction.展开更多
AIM:To evaluate the efficacy of percutaneous imagingguided biliary interventions in the management of acute biliary disorders in high surgical risk patients.METHODS:One hundred and twenty two patients underwent 139 pe...AIM:To evaluate the efficacy of percutaneous imagingguided biliary interventions in the management of acute biliary disorders in high surgical risk patients.METHODS:One hundred and twenty two patients underwent 139 percutaneous imaging-guided biliary interventions during the period between January 2007 to December 2009.The patients included 73 women and 49 men with a mean age of 61 years(range 35-90 years).Fifty nine patients had acute biliary obstruction,26 patients had acute biliary infection and 37 patients had abnormal collections.The procedures were performed under computed tomography(CT)-(73 patients),sonographic-(41 patients),and fluoroscopic-guidance(25 patients).Success rates and complications were determined.The χ2 test with Yates' correction for continuity was applied to compare between these procedures.A P value < 0.05 was considered significant.RESULTS:The success rates for draining acute biliary obstruction under CT-,fluoroscopy-or ultrasoundguidance were 93.3,62.5 and 46.1,respectively with significant P values(P = 0.026 and 0.002,respectively).In acute biliary infection,successful drainage was achieved in 22 patients(84.6).The success rates in patients drained under ultrasound-and CT-guidance were 46.1 and 88.8,respectively and drainage under CT-guidance was significantly higher(P = 0.0293).In 13 patients with bilomas,percutaneous drainage was successful in 11 patients(84.6).Ten out of 12 cases with hepatic abscesses were drained with a success rate of 83.3.In addition,the success rate of drainage in 12 cases with pancreatic pseudocysts was 83.3.The reported complications were two deaths,four major and seven minor complications.CONCLUSION:Percutaneous imaging-guided biliary interventions help to promptly diagnose and effectively treat acute biliary disorders.They either cure the disorders or relieve sepsis and jaundice before operations.展开更多
文摘Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be pal iative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction.
文摘AIM:To evaluate the efficacy of percutaneous imagingguided biliary interventions in the management of acute biliary disorders in high surgical risk patients.METHODS:One hundred and twenty two patients underwent 139 percutaneous imaging-guided biliary interventions during the period between January 2007 to December 2009.The patients included 73 women and 49 men with a mean age of 61 years(range 35-90 years).Fifty nine patients had acute biliary obstruction,26 patients had acute biliary infection and 37 patients had abnormal collections.The procedures were performed under computed tomography(CT)-(73 patients),sonographic-(41 patients),and fluoroscopic-guidance(25 patients).Success rates and complications were determined.The χ2 test with Yates' correction for continuity was applied to compare between these procedures.A P value < 0.05 was considered significant.RESULTS:The success rates for draining acute biliary obstruction under CT-,fluoroscopy-or ultrasoundguidance were 93.3,62.5 and 46.1,respectively with significant P values(P = 0.026 and 0.002,respectively).In acute biliary infection,successful drainage was achieved in 22 patients(84.6).The success rates in patients drained under ultrasound-and CT-guidance were 46.1 and 88.8,respectively and drainage under CT-guidance was significantly higher(P = 0.0293).In 13 patients with bilomas,percutaneous drainage was successful in 11 patients(84.6).Ten out of 12 cases with hepatic abscesses were drained with a success rate of 83.3.In addition,the success rate of drainage in 12 cases with pancreatic pseudocysts was 83.3.The reported complications were two deaths,four major and seven minor complications.CONCLUSION:Percutaneous imaging-guided biliary interventions help to promptly diagnose and effectively treat acute biliary disorders.They either cure the disorders or relieve sepsis and jaundice before operations.
