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Percutaneous Transhepatic Biliary Drainage in Delhi

Biliary Procedures - PTBD and Stenting

Percutaneous Transhepatic Biliary Drainage

Percutaneous Transhepatic Biliary Drainage (PTBD) drains bile, a fluid secreted by the liver to aid digestion, from the liver through the skin. The procedure treats malignant or benign obstructive jaundice.

There are two types of PTBD:

  • Biliary Externalisation

In cases where the wire can not go beyond obstruction or in patients with active infection

  • Biliary Internalisation

Bile drainage happens within the body without an external bag. Doctors use a stent for malignancy. 

Why is it Done?

Malignant Obstructive Jaundice can lead to liver failure and other fatalities. It results from malignant tumours obstructing the common bile duct, preventing bile from flowing into the intestine and allowing it back into the liver.

Surgical resection remains the primary treatment for malignant obstructive jaundice. Still, new techniques like PTBD and stenting are emerging as alternatives. These techniques allow surgeons to drain bile from the liver through special catheters placed through a needle inserted in the skin near the belly button. Surgical resection helps patients with symptoms of jaundice or other complications related to obstructed bile flow.

Malignant obstructive jaundice is often detected when the disease is already at an advanced stage, with an average survival time of under three months. PTBD and stenting exhibit good clinical efficacy and few complications. PTBD and stenting commonly help: 

  • Elderly patients 

  • Patients with inoperable malignant obstructive jaundice.

  • Postoperative recurrence of diabetes and heart diseases. 

Risks

Biliary procedures PTBD and stenting are generally very safe. The risk of complications is low, but it is essential to be aware of the risks involved with these procedures to minimise them.

  • Fever

A common side effect of this procedure usually occurs within the first week after surgery. 

  • Pain

Pain may occur after surgery due to inflammation or infection in the liver or spleen

  • Damage

  • PTBD and stenting may cause some damage to the gallbladder, bile duct, or blood vessels. 

  • Swelling or bleeding around the tube. 

  • Infection in the skin around the pipe. 

  • A blood clot in the liver. 

  • Filling the lungs with blood or air makes breathing hard for the patient.

Preparation

Before the patient undergoes a bile duct procedure, it is essential to prepare by reviewing the following information. 

  • The doctor may recommend complete fasting before the procedure. 

  • Ensure the patient has a family member or a loved one to accompany them during the process. 

  • Avoid drinking alcohol and smoking before the procedure. 

  • Inform the doctor about the health history and all medications, including over-the-counter medicines.

  • Undergo blood tests and electrocardiograms before surgery if the doctor requires them based on the patient's medical condition or test results. 

The Procedure

  • The patient may get general anaesthesia to keep from pain during the procedure. Alternatively, patients may receive local anaesthesia to numb the area under surgery. 

  • The procedure is done under fluoroscopy to ensure accurate placement. 

  • The doctor puts a needle through the abdomen and into the liver. 

  • The doctor pushes a wire into the liver through the needle. 

  • The doctor uses the wire to cross that block the patient's bile duct. 

  • The doctor then puts a tube over the wire.

  • The tube stays inside the body.

  • A small portion of the tube protrudes outside the body. 

    • In the case of Biliary Internalisation, the capped tube drains bile into the intestines.

    • In the case of Biliary Externalisation, the tube stays open as bile drains into an external bag attached to the pipe.

    • In the case of stenting the external tube is removed and bile drains internally via the stent.

After the Procedure

  • Nurses monitor blood pressure, heart rate and other overall health.

  • The doctor recommends medicines to help relax and relieve any pain or nausea the patient might experience. 

  • The patient rests until they are fully awake, usually about an hour after the procedure. 

  • Once awake, the nurses will help the patient walk around to prevent blood clots from forming in the legs or arms. 

  • In that case, most patients can go home within 24 hours of the procedure. 

Why Manipal Hospitals?

At Manipal Hospitals, we believe every patient should have access to the best treatment options, no matter their case. That is why we offer a dedicated tumour board discussion for each patient at our hospital. The board considers all the relevant information and recommends the best treatment based on the patient's case. 

Our expert team is adept at diagnosing and treating the most challenging cases, so patients can rest assured of being in good hands. In addition to our outpatient services, we also provide inpatient services for those who require them. Patients and their families will feel comfortable visiting us because we strive to make hospital visits as pleasant as possible.

Frequently Asked Questions

  • Why should a patient opt for Biliary Procedures and stenting?

PTBD and stenting are an alternative to traditional surgical treatments for obstructive jaundice. It is less invasive than surgery and has a lower risk of infection than biliary stents. Patients often choose it to avoid surgery.

  • Are PTBD and stenting minimally invasive procedures?

PTBD and stenting are minimally invasive procedures requiring tiny incisions through the abdomen.

  • How is the recovery after PTBD and Stenting?

The recovery after PTBD and stenting is quite fast. Most patients can walk around the same day and drive within a few days. However, taking it easy for about a month is essential. The patients should not drive or operate heavy machinery until they have recovered from the procedure.

  • What can a patient eat after Biliary Procedures?

    • After the biliary procedure, doctors recommend fluids only, e.g. water and fruit juice and a thicker liquid diet for the next few days, e.g. clear or smooth soup, milkshakes, and pureed foods. Gradually patients move to fruits and vegetables.

    • Suppose the patient is not feeling well after the procedure or has severe pain or nausea/vomiting. Doctors may recommend an alternate course of diet or treatment.

Summary

Percutaneous Transhepatic Biliary Drainage (PTBD) is a type of procedure that treats obstructive jaundice.

Surgeons drain bile from the liver through special catheters placed through a needle inserted in the skin of the abdomen. The procedure helps patients with symptoms of jaundice or other complications related to obstructed bile flow.

The risks are low, with pain, fever, infection and bleeding possibilities. 

The patient undergoes a procedure under general or local anaesthesia. The doctor puts a needle through the abdomen and into the liver. The doctor uses the wire to cross that block in the patient's bile duct. A small portion of the tube protrudes outside the body, usually for drainage. Most patients can go home within 24 hours of the procedure. In the case of stenting the external tube is removed and bile drains internally via the stent. Visit the best interventional radiology hospital in Delhi to get the finest treatment. 

Experience world-class healthcare at Manipal Hospitals. Our expert team of doctors and state-of-the-art facilities ensure personalized and advanced treatments. Take the first step towards wellness. Book an appointment today.

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