Short-term clinical outcomes of percutaneous biliary tract interventions: analysis of success and complication rates

Abstract

Introduction: Obstructive jaundice is a clinical syndrome that is commonly seen in gastroenterology. Endoscopic retrograde cholangiopancreatography (ERCP) has been recognized as a first-choice therapeutic approach, with percutaneous biliary interventions (PBIs) being a viable alternative. Recent data questions the performance and safety profile of PBIs. Aim: The aim of the present study was to assess retrospectively the short-term clinical outcomes of PBIs in terms of technical and clinical success and adverse events (AEs) rate. Patients and methods: This is a retrospective, single-center cohort study of 62 consecutive patients subjected to PBI between January 2019 and August 2022. Results: Technical and clinical success rates of 97.10% and 79.40%, respectively were established. No PBI showed statistically significant superiority over the others. None of the evaluated factors showed significant influence on the therapeutic outcome and AEs. A total AE rate of 26.5% was calculated. All AEs were moderate to severe (grade III-IV according the Clavien-Dindo system). The mean hospital stay was 7.11±3.68 days. A total of 44.1% of the patients required multiple admissions. Existing studies establish similarly high technical (75%-100%) and acceptable clinical (84%) success rates. Alarmingly high AEs incidence of almost 50% has been found in recently published studies. Infection was the most common adverse event we found in our study. Almost universally, PBIs are used as salvage techniques in patients with malignant disease, failed prior ERCP, and poor performance status. Conclusion: PBIs remain a viable option to ERCP, but stricter patient selection and a gradual transition to EUS-guided draining procedures are likely required.