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Prospective Comparison of Bleeding Complications Between Right and Left Approaches in Percutaneous Biliary Drainage.
Houghton, Eduardo J; Zeledón, Manuel; Acquafresca, Pablo; Finger, Caetano; Palermo, Mariano; Giménez, Mariano E.
Afiliación
  • Houghton EJ; Department of Surgery, University of Buenos Aires.
  • Zeledón M; DAICIM Foundation, Teaching Assistance and Research in Mini-invasive Surgery.
  • Acquafresca P; Hospital Bernardino Rivadavia.
  • Finger C; Department of Surgery, University of Costa Rica, San Jose.
  • Palermo M; DAICIM Foundation, Teaching Assistance and Research in Mini-invasive Surgery.
  • Giménez ME; DAICIM Foundation, Teaching Assistance and Research in Mini-invasive Surgery.
Surg Laparosc Endosc Percutan Tech ; 29(1): 7-12, 2019 Feb.
Article en En | MEDLINE | ID: mdl-30516719
PURPOSE: The present study aimed to determine whether the percentage of bleeding complications differs between the right and the left approaches in percutaneous biliary drainage (PBD) in adult patients. MATERIALS AND METHODS: This was a prospective, descriptive, nonrandomized comparative and longitudinal study. We included adult patients over 18 years of age who underwent a PBD. We excluded those with a bilateral PBD for the comparative study. Usually, but not exclusively, we performed the right approach under fluoroscopic guidance and the left one under ultrasound and fluoroscopy. RESULTS: Of 150 cases, 63 were performed using the right approach and 61 with the left; 26 were performed with the bilateral. The right approach faced less dilated biliary ducts and more benign diseases. We experienced 20 bleeding complications (13.33%, confidence intervals of 95%=8.3-19.8), 7 in the bilateral approach, 10 in the right approach, and 3 in the left one. The difference between the right and the left approaches was statistically significant (Fisher P=0,04). No procedures were required to obtain hemostasis, and only one patient (0.66%, confidence intervals of 95%=0.009-3.66) (in the right side) required a red blood cell transfusion. We found no related mortality. CONCLUSIONS: Global bleeding complications are more likely to appear in the right approach in which less dilated biliary ducts and more benign diseases probably contributed to a higher number of needle passes, portal and hepatic vein punctures, and, therefore, to an increase in the risk of bleeding complications. The significant bleeding complication rate was low (0.66%).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Drenaje / Colestasis / Pérdida de Sangre Quirúrgica Tipo de estudio: Etiology_studies / Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Drenaje / Colestasis / Pérdida de Sangre Quirúrgica Tipo de estudio: Etiology_studies / Evaluation_studies / Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Surg Laparosc Endosc Percutan Tech Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos