“Complementary to percutaneous intra-abdominal drainage, percutaneous transhepatic
biliary drainage (PTBD) might ameliorate healing of pancreatic fistula and biliary leakage after pancreatoduodenectomy by diversion of bile from the site of leakage. Pancreatoduodenectomy is a complex surgical procedure associated with a high risk of complications (50%), even at specialized high-volume centers. A common complication is leakage of the pancreatic anastomosis: i.e. postoperative pancreatic fistula (POPF). The incidence of clinically relevant POPF (grade B/C) is approximately 12%. A less common complication is bile leakage, with an incidence varying between 1 and 4%.”

“Biliary and biliopancreatic leakage after pancreatoduodenectomy are associated with high morbidity and mortality. Percutaneous transhepatic biliary drainage (PTBD) can be performed, in conjunction with percutaneous intra-abdominal drainage, to promote healing of the anastomosis by draining both the biliary tract and jejunal limb of the pancreatico- and hepaticojejunos-tomy.”

Henry AC, et al Biliopancreatic and biliary leak after pancreatoduodenectomy treated by percutaneous transhepatic biliary drainage. HPB (Oxford). 2022 Apr;24(4):489-497. doi: 10.1016/j.hpb.2021.08.941. Epub 2021 Sep 6. Free Full Text