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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2025; 35(03): 411-417
DOI: 10.1055/s-0044-1800877
Original Article

A Retrospective Analysis Comparing Technical Difficulty and Safety between Right and Left-sided Percutaneous Transhepatic Biliary Drainage in a Nondilated Biliary System

Ranjan Kumar Patel 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Taraprasad Tripathy 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Bramhadatta Pattnaik
2   Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Tanmay Dutta
2   Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sunita Gupta
2   Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Hemant Kumar Nayak
3   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Manas Kumar Panigrahi
3   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Deepak Das
4   Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sandip Kumar Barik
4   Department of Radiation Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Sudipta Mohakud 
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Suprava Naik
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Nerbadyswari Deep Bag
1   Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
› Author Affiliations
Funding None.
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Abstract

Objective The aim of this study was to compare the technical difficulty and safety between right-sided percutaneous transhepatic biliary drainage (R-PTBD) and left-sided percutaneous transhepatic biliary drainage (L-PTBD) in patients with nondilated bile ducts.

Materials and Methods Forty-two patients (22 males and 20 females with a mean age of 46.2 ± 13.7 years) who received PTBD in nondilated bile ducts (from September 2021 to January 2024) were dichotomized into the R-PTBD (n = 22) and L-PTBD (n = 20) groups. The number of needle punctures, successful biliary punctures, technical success, difficulty in catheter placement, total fluoroscopic time, total procedure time, overall complications, and hemorrhagic complications were evaluated and compared between the groups.

Results The R-PTBD group had significantly fewer needle punctures for biliary access (3.9 ± 1.3 vs. 4.3 ± 1.3; p = 0.004) and a shorter procedure duration (21 ± 8.5 vs. 29.9 ± 13.2 minutes; p = 0.021) than the L-PTBD group. The successful biliary puncture (20 [90.9%] vs. 15 [75%]; p = 0.229) and technical success rate (20 [90.9%] vs. 14 [70%]; p = 0.123) were also higher for the R-PTBD group than for the L-PTBD group, while R-PTBD required less fluoroscopic time (5.83 [3.5–8.13] vs. 8.16 [4.34–12.9] minutes; p = 0.113). However, these differences did not reach statistical significance (p > 0.05). Further, difficulty during catheter placement was more frequently encountered in the L-PTBD group (02 [9%] vs. 04 [20%]; p = 0.367). The overall complication and hemorrhagic complication rates were comparable between both groups.

Conclusion When both approaches are equally suitable for patients with nondilated bile ducts, R-PTBD may be favored over L-PTBD, given the evidence demonstrating less technical difficulty in the right-sided approach than in the left-sided approach.

Keywords

percutaneous transhepatic biliary drainage - nondilated bile ducts - right-sided versus left-sided PTBD - adverse events - benign biliary system - obstructive biliopathy

Data Availability Statement

Supporting data will be available on contacting the corresponding author.


Authors' Contributions

R.K.P., T.P.T., and N.D.B. conceptualized and designed the study. R.K.P., T.P.T., S.M., T.D., S.G., D.D., S.K.B and S.N. collected the data and S.N. analyzed the data. R.K.P. and T.P.T. prepared the first draft of the manuscript. B.D.P., T.D., S.N., H.K.N., and M.K.P. revised the manuscript with their critical and intellectual inputs. All the authors have seen the manuscript and agree to the results and take full responsibility for the work. Both R.K.P. and T.T. have equally contributed and are considered as the co-first authors.


Ethical Approval

The study was performed conforming to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights. Ethical approval was waived off as per the institute's policy as it was a retrospective study.


Patient Consent

Patient consent is not required due to the retrospective nature of the study.




Publication History

Article published online:
11 February 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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