Comparative Outcomes of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage (PTBD) Due to Malignant Obstructive Jaundice: A Single-Center Retrospective Analysis.
- 1Radiology Unit, Dulbecco University Hospital, 88100 Catanzaro, Italy.
- 2Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
- 3Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies "GF Ingrassia", University Hospital Policlinico "G. Rodolico-San Marco", University of Catania, 95123 Catania, Italy.
Abstract
Background: Percutaneous transhepatic biliary drainage (PTBD) remains a cornerstone in managing obstructive jaundice, particularly when endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful or contraindicated. This study aims to compare ultrasound-guided (US-PTBD) and fluoroscopy-guided (F-PTBD) techniques regarding procedural time, radiation exposure, technical success, and complication rates. Methods: This retrospective, single-center study included patients with malignant obstructive jaundice who underwent PTBD between January 2018 and December 2025. Patients were stratified based on the imaging modality used for the bile duct puncture (US-PTBD vs. F-PTBD). Procedural characteristics, including dose-area product (DAP), fluoroscopy time, complication rates, and technical success, were analyzed using statistical methods appropriate for continuous and categorical data. Results: A total of 133 patients (163 PTBD procedures) were included. US-PTBD demonstrated significantly lower DAP (4.1 ± 1.9 Gy·cm² vs. 6.2 ± 1.5 Gy·cm²; p < 0.001) and shorter procedure time (42 ± 7 min vs. 56.6 ± 6 min; p < 0.001) compared to F-PTBD. Both techniques had comparable technical success rates (91.1% vs. 82.2%; p = 0.158). Complications occurred in 10.2% of patients in the F-PTBD group and 6.7% in the US-PTBD group, with no statistically significant difference between groups (p = 0.489). Major complications, including bleeding and cholangitis, occurred exclusively in the F-PTBD cohort. US-PTBD resulted in fewer Glisson capsule punctures, suggesting reduced procedural trauma. Conclusions: Although a significant access side imbalance was present between cohorts, US-PTBD offers distinct advantages over F-PTBD, including reduced radiation exposure, shorter procedure times, and a comparable safety profile. These findings highlight the potential of US guidance as a safer alternative for PTBD, particularly in patients with coagulopathy or complex anatomy. Further multicenter studies with larger populations are warranted to confirm these benefits and refine patient selection criteria.
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BibTeX
@article{giurdanella2026comparative,
title = {{Comparative Outcomes of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage (PTBD) Due to Malignant Obstructive Jaundice: A Single-Center Retrospective Analysis.}},
author = {Marco Giurdanella and Domenico Laganà and Caterina Battaglia and Giuliana Conti and Nicola De Rosi and Francesco Manti and Giuseppe Mazzeo and Marco Fulciniti and Pier Paolo Arcuri and Claudio Maglia and Francesco Tiralongo and Roberto Minici},
journal = {Life (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/life16101759},
url = {https://europepmc.org/article/MED/42942345},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Outcomes of Ultrasound-Guided Versus Fluoroscopy-Guided Percutaneous Transhepatic Biliary Drainage (PTBD) Due to Malignant Obstructive Jaundice: A Single-Center Retrospective Analysis.
AU - Marco Giurdanella
AU - Domenico Laganà
AU - Caterina Battaglia
AU - Giuliana Conti
AU - Nicola De Rosi
AU - Francesco Manti
AU - Giuseppe Mazzeo
AU - Marco Fulciniti
AU - Pier Paolo Arcuri
AU - Claudio Maglia
AU - Francesco Tiralongo
AU - Roberto Minici
PY - 2026
DA - 2026/10/20
JO - Life (Basel, Switzerland)
DO - 10.3390/life16101759
UR - https://europepmc.org/article/MED/42942345
AB - Background: Percutaneous transhepatic biliary drainage (PTBD) remains a cornerstone in managing obstructive jaundice, particularly when endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful or contraindicated. This study aims to compare ultrasound-guided (US-PTBD) and fluoroscopy-guided (F-PTBD) techniques regarding procedural time, radiation exposure, technical success, and complication rates. Methods: This retrospective, single-center study included patients with malignant obstructive jaundice who underwent PTBD between January 2018 and December 2025. Patients were stratified based on the imaging modality used for the bile duct puncture (US-PTBD vs. F-PTBD). Procedural characteristics, including dose-area product (DAP), fluoroscopy time, complication rates, and technical success, were analyzed using statistical methods appropriate for continuous and categorical data. Results: A total of 133 patients (163 PTBD procedures) were included. US-PTBD demonstrated significantly lower DAP (4.1 ± 1.9 Gy·cm² vs. 6.2 ± 1.5 Gy·cm²; p < 0.001) and shorter procedure time (42 ± 7 min vs. 56.6 ± 6 min; p < 0.001) compared to F-PTBD. Both techniques had comparable technical success rates (91.1% vs. 82.2%; p = 0.158). Complications occurred in 10.2% of patients in the F-PTBD group and 6.7% in the US-PTBD group, with no statistically significant difference between groups (p = 0.489). Major complications, including bleeding and cholangitis, occurred exclusively in the F-PTBD cohort. US-PTBD resulted in fewer Glisson capsule punctures, suggesting reduced procedural trauma. Conclusions: Although a significant access side imbalance was present between cohorts, US-PTBD offers distinct advantages over F-PTBD, including reduced radiation exposure, shorter procedure times, and a comparable safety profile. These findings highlight the potential of US guidance as a safer alternative for PTBD, particularly in patients with coagulopathy or complex anatomy. Further multicenter studies with larger populations are warranted to confirm these benefits and refine patient selection criteria.
SN - 2075-1729
ER -