경피경간담도경 검사를 받는 환자에서 합병증의 위험인자 (Clinical Risk Factors for Complications in Patients Undergoing Percutaneous Transhepatic Cholangioscopy)

서지정보

· 발행기관 : 대한췌장담도학회
· 수록지 정보 : 대한췌담도학회지 / 25권 / 1호 / 55 ~ 63페이지
· 저자명 : 한성용, 김태욱, 김동욱, 박영주, 이문원, 김석, 백동훈, 김광하, 송근암

초록

Background/Aim: Percutaneous transhepatic cholangioscopy (PTCS) has been widely used for the diagnosis and treatment. PTCS-related complications (hemobilia, cholangitis, biliary tract perforations) are not infrequent. However, data on the risk factors for PTCS-related complications are limited. Therefore, we aimed to identify the risk factors for PTCS-related complications.
Methods: Two hundred thirty-three patients who underwent PTCS at a single tertiary center between January 2006 and October 2014 were enrolled. After retrospectively analyzing the patients’ medical records, 212 patients were enrolled and classified into two groups: 1) a complication group and 2) a non-complication group.
Results: The study population comprised 112 men and 100 women, with a median age of 64.5 years. Of the 212 patients, 32 (15.1%) developed complications: 14 (6.7%) developed cholangitis, six (2.8%) developed bile duct injury, and two (0.9%) developed hemobilia. In the univariate analyses, older age, a small number of tract dilatation sessions, and computed tomography (CT) findings of liver cirrhosis and a non-dilated intrahepatic duct were risk factors for PTCS-related complications. In the multivariate analysis, older age, a small number of tract dilatation sessions, and the CT finding of a non-dilated intrahepatic duct were independent factors for predicting PTCS-related complications. Serial tract dilatations (≥2 sessions) were performed in 95 patients (44.8%), but this did not affect the complication rate. In this subgroup of patients, a short interval between sessions (≤3 days) was associated with PTCSrelated complications.
Conclusions: Elderly patients and those with non-dilated intrahepatic ducts on CT need to be managed carefully. Stepwise tract dilatations and a long interval between sessions (>3 days) can help decrease PTCS-related complications.

영어초록

Background/Aim: Percutaneous transhepatic cholangioscopy (PTCS) has been widely used for the diagnosis and treatment. PTCS-related complications (hemobilia, cholangitis, biliary tract perforations) are not infrequent. However, data on the risk factors for PTCS-related complications are limited. Therefore, we aimed to identify the risk factors for PTCS-related complications.
Methods: Two hundred thirty-three patients who underwent PTCS at a single tertiary center between January 2006 and October 2014 were enrolled. After retrospectively analyzing the patients’ medical records, 212 patients were enrolled and classified into two groups: 1) a complication group and 2) a non-complication group.
Results: The study population comprised 112 men and 100 women, with a median age of 64.5 years. Of the 212 patients, 32 (15.1%) developed complications: 14 (6.7%) developed cholangitis, six (2.8%) developed bile duct injury, and two (0.9%) developed hemobilia. In the univariate analyses, older age, a small number of tract dilatation sessions, and computed tomography (CT) findings of liver cirrhosis and a non-dilated intrahepatic duct were risk factors for PTCS-related complications. In the multivariate analysis, older age, a small number of tract dilatation sessions, and the CT finding of a non-dilated intrahepatic duct were independent factors for predicting PTCS-related complications. Serial tract dilatations (≥2 sessions) were performed in 95 patients (44.8%), but this did not affect the complication rate. In this subgroup of patients, a short interval between sessions (≤3 days) was associated with PTCSrelated complications.
Conclusions: Elderly patients and those with non-dilated intrahepatic ducts on CT need to be managed carefully. Stepwise tract dilatations and a long interval between sessions (>3 days) can help decrease PTCS-related complications.

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