Summary: | Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic
biliary drainage (PTBD) catheter in patients with malignant biliary obstruction.
Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction
who underwent 733 PTBD catheter insertions between January 2010 and February 2015.
The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence
of a closed-loop pigtail, and tube diameter were evaluated.
Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in
157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion
until dislodgement was 32 days (range: 1–233 days). Male (odds ratio [OR]: 1.636, 95% confidence
interval [CI]: 1.131–2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080–2.274, p =
0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005–1.026, p = 0.005), and incomplete closedloop
pigtail formation (OR: 1.672, 95% CI: 1.098–2.545, p = 0.016) were independent factors predictive
of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided
approach, increased insertion angle, and incomplete closed-loop pigtail formation.
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