Comparative Outcomes of PTCD and ERCP in Palliative Biliary Drainage

Photo Credit: Guzaliia Filimonova

The following is a summary of “Analysis of the efficacy of Percutaneous Transhepatic Cholangiography Drainage (PTCD) and Endoscopic Retrograde Cholangiopancreatography (ERCP) in the treatment of Malignant Obstructive Jaundice (MOJ) in palliative drainage and preoperative biliary drainage: a single-center retrospective study,” published in the October 2024 issue of Surgery by Cai et al.

Malignant obstructive jaundice (MOJ) is a condition that requires effective drainage techniques, such as percutaneous transhepatic cholangiography drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP), to improve liver function and patients QoL.

Researchers conducted a retrospective study to assess the safety and efficacy of PTCD and ERCP in treating MOJ.

They enrolled 520 patients with MOJ who underwent either PTCD or ERCP, classifying them into palliative drainage and preoperative biliary drainage groups. Baseline characteristics were compared, liver function, blood routine, and complications (P<0.001).

The results showed the technical success rates for PTCD and ERCP in the palliative group were 97.1% and 85.9%, respectively. The PTCD demonstrated higher total bilirubin (TB) reduction (53.0 (30.0, 97.0) vs. 36.8 (17.9, 65.0), P<0.001) and direct bilirubin (DB) reduction (42.0 (22.0, 78.5) vs. 28.0 (12.0, 50.8), P=0.001) compared to ERCP. However, PTCD had higher drainage tube displacement (20 cases, 11.8%), while ERCP had more biliary infections (39 cases, 22.8%) and pancreatitis (7 cases, 4.1%). In the preoperative drainage group, PTCD achieved a 50% TB reduction faster than ERCP (7.1 days vs. 10.5 days). The time from palliation of jaundice to surgery was significantly shorter in the PTCD group (24.2 days) than in the ERCP group (35.7 days, P=0.017).

They concluded that both PTCD and ERCP improved liver function for patients with MOJ, but PTCD may provide superior outcomes in palliative drainage and is preferable for preoperative biliary drainage.

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02595-w

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