Abstract:
Background: Obstructive jaundice is a specific type of jaundice, where symptoms
develop due to a narrowed or blocked biliary tree, preventing the normal drainage of
bile from the liver into the intestines. It can have benign causes such as gallstones or
malignant causes such as pancreatic cancer. Malignant causes are the majority and by
the time of diagnosis, they are usually advanced with most patients exhibiting a poor
clinical status. Percutaneous Transhepatic Biliary Drainage (PTBD) is an imagingguided
procedure performed by an interventional radiologist for biliary drainage in
both benign and malignant cases including palliation. It is a relatively new specialty in
Kenya and as such a study on PTBD and information on the clinical and laboratory
parameters pre and post drainage as well as on the associated immediate
complications, is due for Kenya and Sub-Saharan Africa.
Objectives: To evaluate outcomes pre and post PTBD and assess the complications
from the PTBD procedure.
Materials and Methods: A prospective study was conducted at the Moi Teaching and
Referral hospital, in the Interventional Radiology section for a period of 12 months.
All the patients with obstructive jaundice requiring PTBD who were sent to the
interventional radiology unit for PTBD placement from the medical and surgical
wards were recruited. Biodata and data on pruritus were collected using
questionnaires whereas data on laboratory measurements were extracted from the
patient records during the 2 week follow-up period. Analysis was done using
Statistical Package for Social Sciences version 21. Descriptive statistics including
mean, mode, and median, measures of dispersion, frequencies, and proportions were
used for the analysis. The results are presented in form of tables, figures, and prose
format.
Results: Among the 66 patients included in the study, 53% were male while the rest
were female. The majority of the patients showed clinical improvement in pruritus
post PTBD. There was a statistically significant reduction in aspartate
aminotransferase (AST), alanine phosphatase (ALP), total bilirubin, and Gamma
Glutamyl transferase (GGT) after PTBD with ( A p value< 0.005). A total of 35
(53.0%) of the patients had major complications while 25 (42.4%) had minor
complications after the PTBD procedure.
Conclusion: PTBD improved patient clinical and laboratory parameters and minor
complications were mostly encountered in this study
Recommendations: PTBD uptake should be encouraged and further studies should
be done to determine the quality of life post-PTBD procedure to relate whether
improved laboratory and clinical outcomes translate to a better quality of life.
