FEWER COMPLICATIONS FOLLOWING PERCUTANEOUS-TRANSHEPATIC-ENDOSCOPIC RENDEZVOUS PROCEDURES COMPARED TO PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY ALONE

Aims:

Biliary drainage can be challenging in cases of refractory bile duct obstruction and percutaneous-transhepatic-endoscopic rendezvous procedures (PTE-RVs) might facilitate biliary drainage even in these cases This study evaluated the safety and the technical success of PTE-RVs in comparison to those of percutaneous transhepatic cholangiografies (PTCs) for biliary drainage.

Methods:

Over a 10-year period, percutaneous procedures were retrospectively analyzed in our tertiary referral center. The examinations were accomplished due to a previous or expected failure of standard endoscopic methods including ERC or balloon-assisted ERC to achieve biliary access.

Results:

In total, 553 percutaneous procedures including 163 PTE-RVs and 390 PTCs were performed in 244 patients during the 10-year period of observation. 71.3% of the patients had a malignant disease with pancreas-carcinoma (32.8%) and cholangio-carcinoma (19.0%) as the most frequent, while 28.7% of the patients had a benign disease with cholelithiasis (45.7%) and postoperative biliodigestive anastomotic strictures (31.4%) as the most frequent conditions. 50.8% of the patients had a postoperative change in bowel anatomy.

The technical success rate of PTCs was very high (89.7%) and although the technical success rate of PTE-RVs was significant lower, it was still high (80.4%; p < 0.003). Overall, adverse events occurred in 23.5% of all examinations; comparing, significantly less complications occurred following PTE-RVs than following PTCs (16.6% vs. 26.4%; p = 0.037).

Conclusions:

Rendezvous procedures offer a high technical efficacy and significant less complications happen following PTE-RVs in comparison to PTCs. Considering this, PTE-RV should be preferred over sole PTC in terms of safety.