Factors Affecting Length of Stay after Percutaneous Biliary Interventions.

OBJECTIVE::To evaluate the factors affecting the length of hospital stay (LOS) after percutaneous transhepatic biliary drainage (PTBD).METHODS::A retrospective review of all patients who had undergone PTBD with or without stenting at a UK specialist centre between 2005 and 2016 was conducted.RESULTS::692 patients underwent 1976 procedures over 731 clinical episodes for which, the median age was 65 (range 18-100) years, and the median Charlson Index was 3. PTBD was performed for malignant (n = 563) and benign strictures (n = 60), stones (n = 62), and bile leaks (n = 46). The median LOS was 13 (range 0-157) days, and the median interprocedure duration was 9 (range 0-304) days. The median number of procedures per patient was 2 and the median number of days required to complete a set of procedures for a patient (TBID) ranged from 0 to 557 days, with a median of 16 (interquartile range: 8-32) days. Patients with biliary leak had the highest LOS. Biliary stents were mostly placed at the second stage at a median of 6 (range 0-120) days from the first procedure day. Placement of a biliary stent in the first stage of the procedure was associated with shorter LOS (p < 0.001).CONCLUSIONS::Biliary stenting at index procedure reduces LOS, although it is not always technically possible. Patients with bile leak managed with PTBD have longer LOS.ADVANCES IN KNOWLEDGE::This study provides data which can help in appropriate consenting, better planning, and efficient resource utilization for patients undergoing PTBD.