PREVENTION OF HEMOBILIA DURING PERCUTANEOUS BILIARY DRAINAGE - LONG-TERM FOLLOW-UP

PURPOSE: The authors evaluated a technique for the prevention of hemob ilia when placing transhepatic biliary drainage catheters (THBDCs). MA TERIALS AND METHODS: Initially, 20 patients were randomized into two g roups, In the control group, a THBDC was placed after blind needle pas sage without contrast material opacification of the needle tract, In t he experimental group, the tract was studied and then abandoned if a m ajor vascular structure was encountered, Once a tract was found that d id not traverse a major vascular structure, a THBDC was placed, An add itional 35 patients undergoing 40 procedures were studied with use of the technique as outlined for the original experimental group, The ori ginal experimental group patients and the additional 35 patients were followed for up to 3 years. RESULTS: There were three cases of hemobil ia in the initial control group, None of the patients in the initial e xperimental group experienced hemobilia, In the additional 35 patients , there were three cases of bloody drainage from the THBDC; however, t he etiology of hemobilia was not secondary to transgression of a vascu lar structure. CONCLUSION: Visualization of the tract prevents the usa ge of tracts that communicate with large vascular structures, This tec hnique reduces the incidence of hemobilia when placing THBDCs.