Percutaneous Transhepatic Biliary Drainage Using a Ligated Catheter for Recurrent Catheter Obstruction: Antireflux Technique
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Percutaneous transhepatic biliary drainage (PTBD) is an established procedure for biliary obstruction. However, duodenobiliary or jejunobiliary reflux of the intestinal contents through a PTBD catheter sometimes causes recurrent catheter obstruction or cholangitis. A 64-year-old female patient with a history of choledochojejunostomy was referred to our department with acute cholangitis due to choledochojejunal anastomotic obstruction. Emergent PTBD was performed,but frequent obstructions of the catheter due to the reflux of intestinal contents complicated the post-PTBD course. We therefore introduced a catheter with an antireflux mechanism to prevent jejunobiliary reflux. A commercially available catheter was modified; side holes were made at 1 cm and 5 to 10 cm (1 cm apart) from the tip of the catheter, and the catheter was ligated with a nylon thread just proximal to the first side hole. Using this novel “antireflux PTBD technique,”jejunobiliary reflux was prevented successfully, resulting in a longer patency of the catheter
Abstract
Percutaneous transhepatic biliary drainage (PTBD) is an established procedure for biliary obstruction. However, duodenobiliary or jejunobiliary reflux of the intestinal contents through a PTBD catheter sometimes causes recurrent catheter obstruction or cholangitis. A 64-year-old female patient with a history of choledochojejunostomy was referred to our department with acute cholangitis due to choledochojejunal anastomotic obstruction. Emergent PTBD was performed,but frequent obstructions of the catheter due to the reflux of intestinal contents complicated the post-PTBD course. We therefore introduced a catheter with an antireflux mechanism to prevent jejunobiliary reflux. A commercially available catheter was modified; side holes were made at 1 cm and 5 to 10 cm (1 cm apart) from the tip of the catheter, and the catheter was ligated with a nylon thread just proximal to the first side hole. Using this novel “antireflux PTBD technique,”jejunobiliary reflux was prevented successfully, resulting in a longer patency of the catheter
참고문헌 (8)
- Takada T, "Percutaneous transhepatic cholangial drainage: direct approach under fluoroscopic control", J Surg Oncol, 8, pp.83~97 (1976)
- Nagino M, "Percutaneous transhepatic biliary drainage in patients with malignant biliary obstruction of the hepatic confluence", Hepatogastroenterology, 39, pp.296~300 (1992)
- McPherson GA, "Percutaneous transhepatic drainage in obstructive jaundice: advantages and problems", Br J Surg, 69, pp.261~264 (1982)
- Blenkharn JI, "Septic complications of percutaneous transhepatic biliary drainage. Evaluation of a new closed drainage system", Am J Surg, 147, pp.318~321 (1984)
- Joseph PK, "Percutaneous transhepatic biliary drainage. Results and complications in 81 patients", JAMA, 255, pp.2763~2767 (1986)
- Audisio RA, "The occurrence of cholangitis after percutaneous biliary drainage: evaluation of some risk factors", Surgery, 103, pp.507~512 (1988)
- Morita S, "Septic shock after percutaneous transhepatic drainage of obstructed afferent loop: case report", Cardiovasc Intervent Radiol, 12, pp.66~68 (1989)
- Moriura S, "Jaundice due to afferent loop obstruction following hepatectomy for a hilar cholangiocarcinoma", Abdom Imaging, 21, pp.226~227 (1996)