Correlation between Percutaneous Biliary Drainage and Decrease in Serum Bilirubin

Main Article Content

César Hayashi-Mercado
Miguel González-Urueta
Gabriel Luna-López
Abelardo Aguilar-West

Abstract

Background: Obstruction of the bile duct, whether caused by a tumor or a surgical injury,  will cause: jaundice, elevated liver enzymes, and eventually,  liver failure. The primary goal of percutaneous management is draining bile into the small intestine and achieving a drainage that is the most similar to the normal physiologic drainage, maintaining normal enterohepatic circulation. The present study aims to make a correlation between percutaneous biliary diversion and the decrease in serum bilirubin in pre- and post-procedure studies (24 hours).


Methods: We did a retrospective review of the database of the Interventional Radiology service of Hospital Regional 11º de Octubre, México. The time study was  between years 2017 and 2022. We analyzed 75 patient’s clinical records who underwent percutaneous management with a diagnosis of bile duct dilation due to an obstructive origin. The population was divided in three groups benign, malignant and post-surgical based on the ethiology of the bile duct obstruction.  Total serum bilirubins, liver enzymes, coagulation tests and platelets of each patient were obtained from the clinical record prior to percutaneous biliary diversion and 24 hours after  procedure.


Results: 75 patient records were explored, of which 26 (34.7%) were men and 49 (65.3%) were women The mean age was 62.3 years. A  statistically significant decrease in total serum bilirubin was observed 24 hr after the procedure with a p value of 0.009. A statistically significant decrease  after the procedure was also observed in liver enzymes with  a value of: GGT with p: 0.002, GOT with p: 0.003 and LDH with p: 0.005


Discussion:  There was a decrease in total serum bilirubin and liver enzymes after an effective biliary diversion, regardless of the cause of obstruction.

Article Details

How to Cite
Hayashi-Mercado, C. ., González-Urueta, M. ., Luna-López, G. ., & Aguilar-West, A. . (2023). Correlation between Percutaneous Biliary Drainage and Decrease in Serum Bilirubin. International Journal of Medical Science and Clinical Research Studies, 3(4), 713–718. https://doi.org/10.47191/ijmscrs/v3-i4-25
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References

I. Zhao, X., Dong, J., Jiang, K., Huang, X., & Zhang, W. (2015). Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: A meta‐analysis. Digestive Endoscopy, 27(1), 137-145. https://doi.org/10.1111/den.12320

II. Ibrarullah, Md., Sankar, S., Sreenivasan, K., & Gavini, S. R. K. (2015). Management of Bile Duct Injury at Various Stages of Presentation: Experience from a Tertiary Care Centre. Indian Journal of Surgery, 77(2), 92-98. https://doi.org/10.1007/s12262-012-0722-2

III. Martin D, Uldry E, Demartines N, Halkic N. Bile Duct Injuries After Laparoscopic Cholecystectomy: 11-Year Experience in a Tertiary Center. BST. 2016;10(3):197-201.https://doi.org/10.5582/bst.2016.01065

IV. Kokas, B., Szijártó, A., Farkas, N., Ujváry, M., Móri, S., Kalocsai, A., & Szücs, Á. (2021). Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients. PLOS ONE, 16(11), e0260223. https://doi.org/10.1371/journal.pone.0260223

V. Kucukay, F., Sarper, O., Yurdakul, M., Ozdemir, E., Parlak, E., Olcer, T., & Cumhur, T. (2010). Percutaneous management of malignant biliary disease: Factors that influence ability to overcome the stricture. Diagnostic and Interventional Radiology. https://doi.org/10.4261/1305-3825.DIR.3259-09.3

VI. Popat, B., Thakkar, D., Deshmukh, H., & Rathod, K. (2017). Percutaneous Transhepatic Biliary Drainage in the Management of Post-surgical Biliary Leaks. Indian Journal of Surgery, 79(1), 24-28. https://doi.org/10.1007/s12262-015-1418-1

VII. Xu, X., Yang, L., Chen, W., & He, M. (2021). Transhepatic hilar approach for Bismuth types III and IV perihilar cholangiocarcinoma with long-term outcomes. Journal of International Medical Research, 49(5), 030006052110083. https://doi.org/10.1177/03000605211008336

VIII. Fan, S., Yang, L., Cao, X., & Zhang, X. (2022). The “Hand as Foot” teaching method in Bismuth-Corlette classification of hilar cholangiocarcinoma. Asian Journal of Surgery, S1015958422002184. https://doi.org/10.1016/j.asjsur.2022.02.049

IX. Mansour, J. C., Aloia, T. A., Crane, C. H., Heimbach, J. K., Nagino, M., & Vauthey, J.-N. (2015). Hilar Cholangiocarcinoma: Expert consensus statement. HPB, 17(8), 691-699. https://doi.org/10.1111/hpb.12450

X. de Jong, E. A., Moelker, A., Leertouwer, T., Spronk, S., Van Dijk, M., & van Eijck, C. H. J. (2013). Percutaneous Transhepatic Biliary Drainage in Patients with Postsurgical Bile Leakage and Nondilated Intrahepatic Bile Ducts. Digestive Surgery, 30(4-6), 444-450. https://doi.org/10.1159/000356711

XI. Renz, B. W., Bösch, F., & Angele, M. K. (2017). Bile Duct Injury after Cholecystectomy: Surgical Therapy. Visceral Medicine, 33(3), 184-190. https://doi.org/10.1159/000471818

XII. Tsuyuguchi, T., Takada, T., Kawarada, Y., Nimura, Y., Wada, K., Nagino, M., Mayumi, T., Yoshida, M., Miura, F., Tanaka, A., Yamashita, Y., Hirota, M., Hirata, K., Yasuda, H., Kimura, Y., Strasberg, S., Pitt, H., Büchler, M. W., Neuhaus, H., … Sachakul, V. (2007). Techniques of biliary drainage for acute cholangitis: Tokyo Guidelines. Journal of Hepato-Biliary-Pancreatic Surgery, 14(1), 35-45. https://doi.org/10.1007/s00534-006-1154-9

XIII. Miura, F., Okamoto, K., Takada, T., Strasberg, S. M., Asbun, H. J., Pitt, H. A., Gomi, H., Solomkin, J. S., Schlossberg, D., Han, H.-S., Kim, M.-H., Hwang, T.-L., Chen, M.-F., Huang, W. S.-W., Kiriyama, S., Itoi, T., Garden, O. J., Liau, K.-H., Horiguchi, A., … Yamamoto, M. (2018). Tokyo Guidelines 2018: Initial management of acute biliary infection and flowchart for acute cholangitis. Journal of Hepato-Biliary-Pancreatic Sciences, 25(1), 31-40. https://doi.org/10.1002/jhbp.509

XIV. Duan, F., Cui, L., Bai, Y., Li, X., Yan, J., & Liu, X. (2017). Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: A systematic review and meta-analysis. Cancer Imaging, 17(1), 27. https://doi.org/10.1186/s40644-017-0129-1

XV. Filipović, A. N., Mašulović, D., Zakošek, M., Filipović, T., & Galun, D. (2021). Total Fluoroscopy Time Reduction During Ultrasound- and Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage Procedure: Importance of Adjusting the Puncture Angle. Medical Science Monitor, 27. https://doi.org/10.12659/MSM.933889

XVI. Weber, A., Gaa, J., Rosca, B., Born, P., Neu, B., Schmid, R. M., & Prinz, C. (2009). Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. European Journal of Radiology, 72(3), 412-417. https://doi.org/10.1016/j.ejrad.2008.08.012

XVII. Lee, W., Kim, G. C., Kim, J. Y., Baik, S. K., Lee, H. J., Kim, H. J., & Ryeom, H. K. (2008). Ultrasound and fluoroscopy guided percutaneous transhepatic biliary drainage in patients with nondilated bile ducts. Abdominal Imaging, 33(5), 555-559. https://doi.org/10.1007/s00261-007-9349-3