Comparison of C-arm CT fluoroscopy and conventional fluoroscopy for percutaneous biliary drainage procedures

PURPOSE: To conduct a prospective randomized evaluation of Carm computed to mography (CT) fluoroscopy for external biliary drainage procedures in compa rison with conventional fluoroscopic guidance to reduce the number of trans hepatic punctures as a primary endpoint. MATERIALS AND METHODS: In 18 patients with biliary obstructions, 20 externa l percutaneous biliary drainage procedures were prospectively performed wit h use of either C-arm CT fluoroscopy or conventional fluoroscopy alone. The number of hepatic punctures, procedure time, and fluoroscopy time, were an alyzed separately for both methods. RESULTS: C-arm CT fluoroscopy resulted in a reduced number of transhepatic punctures, with decreased procedure and fluoroscopy times (P < .05; t test) . When compared with conventional external biliary drainage procedures, a m ean of 1.8 +/- 1 versus 4.8 +/- 2.8 hepatic punctures at a fluoroscopy time of 3.4 +/- 1.5 versus 11.4 +/- 7.4 minutes was required for C-arm CT fluor oscopy, while procedure times were 11 +/- 3.6 versus 16.2 +/- 9.3 minutes. CONCLUSIONS: C-arm CT fluoroscopy is associated with decreased procedure an d fluoroscopy times, while fewer transhepatic punctures are required to est ablish external biliary drainage.