Reduction in 30-Day Readmissions by Initial Insertion of Larger Bore Biliary Drainage Catheters

Sunday, March 30, 2025

4:21 PM – 4:30 PM CT

Location: Music City Center, 205 A

Presenting Author(s)

M. Saad Malik, MD (he/him/his)

PGY-2, Integrated Interventional Radiology Resident
UT Southwestern Medical School, United States

Author/Co-author(s)

Kalei Hering

Medical Student
Harvard Medical School, United States
Seth Berkowitz, MD

Interventional Radiologist
Beth Israel Deaconess Medical Center, United States
MA

Muneeb Ahmed, MD, FSIR

Professor of Radiology
Beth Israel Deaconess Medical Center/Harvard, United States
Jeffrey Weinstein, MD, FSIR

Assistant Professor of Radiology
Beth Israel Deaconess Medical Center, United States
Ammar Sarwar, MD, FSIR (he/him/his)

Associate Professor of Radiology
Beth Israel Deaconess Medical Center, United States

Purpose: Readmission rates after percutaneous biliary drainage (PTBD) of over 40 percent are among the highest of IR procedures, many of which may be attributed to catheter malfunction {1,2}. This study evaluates the impact of larger bore biliary drainage catheters ( >8 French) on 30-day readmission rates following percutaneous transhepatic biliary drainage (PTBD) procedures.

Materials and Methods: A retrospective cohort analysis was conducted at a tertiary care hospital, following IRB approval and compliance with HIPAA regulations. We identified patients undergoing PTBD using CPT code 47511. Data collected included patient demographics, causes of biliary obstruction, catheter size (10 French and 8 French), and readmission outcomes categorized into IR-related and non-IR-related. Readmissions were further classified as preventable or unpreventable.

Results: The study population included 330 patients (51% male, 49% female), with a mean age of 64.5 years. The causes of obstruction were primarily malignancy (65%), followed by stones (25%) and benign conditions (10%). Of unilateral placements, 76% were right-sided. The overall 30-day readmission rate was 36% (n=118), with a significantly lower rate in procedures using larger bore catheters ( >8 French, 34%, 98/292) compared to those using 8 French catheters (53%, 20/38; p=0.02). Among readmissions, 79% were unplanned, with 70% determined to be IR-related. The three most common causes for IR-related readmissions included acute cholangitis (40%), abdominal pain (17%), and leakage from the PTBD site (12%).

Conclusion: The utilization of larger bore biliary drainage catheters significantly reduced 30-day readmissions after PTBD procedures, indicating a potential strategy to enhance patient outcomes and reduce healthcare costs associated with unplanned readmissions. Future studies should explore the mechanisms behind these findings to further optimize biliary drainage interventions.