Efficiency of percutaneous transhepatic biliary stent implantation in management of obstructive biliary pathologies: a study in a tertiary care hospital in eastern india

Objectives:Treatment by percutaneous biliary drainage and stenting plays an important role in the management of the patients of obstructive biliary pathologies presenting in poor general condition and inoperable state. Drainage or stenting in patients with malignant biliary obstruction not only can relieve the symptoms and signs of obstructive jaundice but also optimizes the patient’s condition for surgical resection or for receiving palliative chemotherapy or radiotherapy, bringing about an improvement in their quality of life, even if only for a matter of weeks or months. In this study we have retro-spectively evaluated the efficiency of percutaneous transhepatic biliary stent implantation in management of obstructive biliary pathologies presented in our institute.
Methods: A retrospective study was done at our institute between February 2018 to February 2019. 16 patients of obstructive jaundice due to obstructive biliary pathologies admitted at our institute were included in the study after they met the inclusion criteria.
Results: In our study, the average age of male patients was 62 years and that of female patients was 56 years. The overall average age was 58.6±2.8 years. As our institute has a regional cancer centre, most of the patients admitted had malignant biliary obstruction (87.5% ). Among them, bile duct involvement of most of them (57.1%) was of Bismuth Type 1. Most (42.8%) of the malignant biliary strictures were due to cholangiocarcinoma. The most striking result of our study was that all the PTBD with SEMS implantation cases were successful and in each of the cases the direct bilirubin level came to subclinical level within 3 weeks.
Conclusion: PTBD with stent implantation offers a safe and effective method in providing palliative treatment for patients with biliary obstruction. At times, it can be considered as an alternative of endoscopic stent placement in a hospital with well equipped IR set up due to its shorter on table time, shorter post operative hospital stay, ability and effectivity in management of biliary obstruction at different levels.