Abstract Aims The aim of this study was to analyse outcomes for patients undergoing percutaneous transhepatic cholangiography (PTC) for biliary obstruction in order to identify factors associated with improved outcomes. The goal was to refine patient selection and improve the consent process for PTC in the future. Methods A retrospective analysis was performed on all patients undergoing PTC at a single tertiary centre over a 3-year period (2020–2022). Patient demographics, underlying diagnoses, and outcomes were reviewed. Key outcomes included length of hospital stay, serum bilirubin change pre- and post-PTC, 30- and 90-day mortality, survival post-PTC, and whether palliative chemotherapy was administered. Results In total, 41 patients underwent 49 PTC procedures; only index procedures were analysed. The majority (92.7%) had malignant biliary obstruction, with the most common diagnoses being cholangiocarcinoma (29.2%) and pancreatic cancer (26.8%). Average pre-PTC bilirubin was 303.5 µmol/L, decreasing by 39.9% on average. Thirty-day and 90-day mortality rates were 29.2% and 48.7%, respectively, and mean survival post-PTC was 136.9 days. Seven patients (19%) received palliative chemotherapy following PTC. Patients with cholangiocarcinoma and pancreatic cancer had the longest survival, while those with primary liver malignancy had the poorest outcomes. Younger patients exhibited unexpectedly lower survival rates compared to older cohorts. Conclusions PTC provides moderate benefit for bilirubin reduction and facilitates palliative chemotherapy in select patients. Younger patients demonstrated poorer survival, potentially reflecting more aggressive disease biology. Future work should focus on refining patient selection, particularly regarding intent—symptom relief versus enabling further treatment.
Groundwater et al. (Fri,) studied this question.