By Country

By City

Enquire now in case of any assistance needed

PTBD Externo Internalisation Treatment Cost in India

  • PTBD Externo Internalisation Treatment Cost in India is between USD 400 - USD 1000

  • Hospital Days: 2 -3

  • Procedure Duration: 1 Hrs - 2 Hrs

Get Your Estimate Cost

200+
800+
400+
45+

PTBD Externo Internalisation refers to a medical procedure where a percutaneous transhepatic biliary drainage (PTBD) catheter is initially placed externally, and then, after a period, the drainage route is internalized. This technique involves external drainage initially to manage biliary leaks or obstructions, followed by an internalization process where the catheter is redirected internally, often through a stent, allowing for ongoing drainage without the external collection system. This approach may be chosen based on the specific characteristics of the biliary condition, providing a controlled transition from external to internal drainage to optimize patient care and outcomes while addressing underlying biliary issues.

Why Do You Need PTBD Externo Internalisation?

PTBD Externo Internalisation is employed for specific clinical scenarios where percutaneous transhepatic biliary drainage (PTBD) is initially performed externally, followed by an internalization process. Here are key reasons for opting for PTBD Externo Internalisation:

  • Biliary Leak or Obstruction Management: PTBD Externo Internalisation is utilized when addressing complex biliary leaks or obstructions. The initial external drainage allows for controlled diversion of bile, managing symptoms and preventing complications.
  • Transition to Internal Drainage: The procedure facilitates a controlled transition from external to internal drainage. After an initial period of external drainage, the catheter is internalized through a stent, allowing ongoing biliary drainage without needing an external collection system.
  • Minimally Invasive Approach: PTBD Externo Internalisation is considered a minimally invasive procedure compared to traditional surgical interventions. It is performed in an interventional radiology setting, reducing the invasiveness of the treatment and promoting faster recovery.
  • Stent Placement: Internalization often involves placing a stent, which creates a conduit for bile drainage within the body. Stents help maintain the patency of the drainage route and provide a stable internal drainage pathway.
  • Preservation of Function: Internalization helps preserve the natural function of the biliary system. By redirecting the drainage internally, the procedure aims to restore the physiological flow of bile, contributing to improved overall biliary function.
  • Individualized Patient Care: PTBD Externo Internalisation allows for a tailored approach to patient care. The decision to internalize the drainage is based on individual patient needs, the characteristics of the biliary condition, and the overall treatment plan.

Types of PTBD Externo Internalisation

Percutaneous Transhepatic Biliary Drainage Externo Internalisation involves an initial external drainage phase and internalization through a stent. The specific type of internalization may vary based on clinical considerations. Here are common types:

  • Single Stent Internalisation: This involves placing a single stent to internalize the drainage route. The stent maintains the biliary duct's patency, allowing for ongoing internal drainage without the need for an external catheter.
  • Double Stent Internalisation: In some cases, two stents may be used during internalization. This approach may address complex biliary anatomy or provide additional support and stability to the drainage pathway.
  • Covered Stent Internalisation: A covered stent may internalize the drainage route. Covered stents are designed to fully encase the drainage pathway, preventing bile leakage and promoting a more controlled internal drainage.
  • Bilateral Internalisation: Internalization can involve stent placement on both sides of the biliary system, allowing for comprehensive drainage. This approach is considered in cases of bilateral biliary issues or when more extensive internal drainage is required.
  • Fluoroscopic-Guided Internalisation: The internalization process is typically guided by fluoroscopy, allowing real-time visualization of the catheter and stent placement. This ensures precision and accuracy during the internalization phase.

How Patients are Selected for the Procedure? 

The selection of patients for PTBD Externo Internalisation involves carefully evaluating their medical history, clinical presentation, and the nature of the biliary condition. The decision is typically made collaboratively by a multidisciplinary healthcare team, including gastroenterologists, interventional radiologists, and surgeons. Here are key considerations in patient selection:

  • Diagnostic Assessments: Patients undergo thorough diagnostic evaluations, including imaging studies such as ultrasound, CT scans, or MRCP. These tests help identify the extent and characteristics of biliary leaks or obstructions, guiding decision-making.
  • Clinical Presentation: The severity of symptoms and the clinical presentation play a crucial role. PTBD Externo Internalisation is often considered for patients experiencing complex biliary leaks, obstructions, or other complications that warrant intervention.
  • Overall Health Status: The patient's health is assessed to ensure they can tolerate the procedure and potential internalization. Factors such as comorbidities, organ function, and general well-being are considered.
  • Multidisciplinary Collaboration: The decision to proceed with PTBD Externo Internalisation is often made in collaboration with a multidisciplinary team. Specialists from different fields contribute their expertise to ensure a comprehensive evaluation and a well-rounded approach to patient care.
  • Patient Consent: Informed consent is obtained from the patient before the procedure. This involves explaining the purpose of the PTBD Externo Internalisation, potential risks, benefits, and alternative treatment options, allowing patients to make informed decisions about their care.
  • Treatment Goals: The appropriateness of PTBD External Internalisation is determined based on the patient's specific treatment goals. These may include addressing biliary leaks, obstructions, or other conditions that necessitate drainage and internalization.

Risks and Benefits Associated with the Chosen PTBD Externo Internalisation

Benefits of PTBD Externo Internalisation:

  • Comprehensive Biliary Drainage: PTBD Externo Internalisation provides a comprehensive solution for biliary drainage. The initial external drainage allows symptom relief and controlled bile diversion, while internalization through a stent creates a stable pathway for ongoing drainage.
  • Minimally Invasive Nature: PTBD Externo Internalisation is minimally invasive compared to traditional surgical interventions. The procedure is performed in an interventional radiology setting, reducing recovery times and potential complications associated with more extensive surgeries.
  • Preservation of Biliary Function: Internalization through a stent helps preserve the natural flow of bile within the body. This can contribute to improved biliary function and overall patient well-being.

Risks of PTBD Externo Internalisation:

  • Infection: There is a risk of infection associated with the internalization procedure, particularly during the initial external drainage phase. Strict sterile techniques are employed, but infections may still occur.
  • Bleeding: The internalization process poses a risk of bleeding, although this risk is relatively low. Continuous monitoring for signs of bleeding and prompt intervention if necessary are crucial aspects of post-procedural care.
  • Stent-related Complications: Using stents introduces potential complications such as stent migration, blockage, or infection. Regular follow-up and monitoring are essential to promptly address and manage any stent-related issues.
  • Perforation: In rare instances, internalization may lead to perforation of surrounding structures. The risk is minimized through precise catheter and stent placement, but careful monitoring for signs of perforation is crucial.
  • Catheter Dislodgment: External catheter dislodgment during the initial phase of external drainage may occur, impacting the procedure's effectiveness. Proper catheter care and patient education are essential to mitigate this risk.

PTBD Externo Internalisation offers significant benefits in terms of comprehensive biliary drainage with a minimally invasive approach. However, like any medical intervention, it is associated with certain risks that require careful consideration and management to ensure optimal patient outcomes. The decision to proceed with PTBD Externo Internalisation is made based on a thorough assessment of the patient's condition and treatment goals.

What to Expect After a PTBD Externo Internalisation?

After undergoing Percutaneous Transhepatic Biliary Drainage (PTBD) Externo Internalisation, patients can anticipate a post-procedural recovery period with specific expectations for care and follow-up. Here's what to expect:

  • Immediate Post-Procedure Monitoring: Following PTBD Externo Internalisation, patients are monitored closely in a recovery area. Vital signs are observed, and immediate post-procedural discomfort or complications are promptly addressed.
  • Pain Management: Patients may experience some discomfort at the catheter insertion site or in the abdominal region. Pain management strategies, including analgesic medications, may be provided to alleviate any post-procedural pain or discomfort.
  • Catheter Care Instructions: Patients will receive detailed instructions on caring for the external drainage catheter during the initial phase. This includes maintaining cleanliness, monitoring for signs of infection, and ensuring the secure positioning of the catheter to prevent dislodgment.
  • Transition to Internal Drainage: Over the following days or weeks, the external catheter is internalized through the placement of a stent. This transition is typically performed in a controlled manner to ensure ongoing biliary drainage without the need for an external collection system.
  • Monitoring for Complications: Close monitoring for potential complications, such as infection, bleeding, stent-related issues, or catheter dislodgment, is essential during the post-procedural period. Healthcare providers will assess the patient's condition and intervene to address potential complications.
  • Follow-up appointments: Scheduled follow-up appointments with the healthcare team are crucial. These appointments allow for assessing the effectiveness of internal drainage, monitoring for any ongoing issues, and addressing patient concerns.
  • Symptom Improvement: As the internal drainage stabilizes and addresses the underlying biliary issues, patients can expect improvement in symptoms such as abdominal pain, jaundice, and other discomforts associated with biliary complications.
  • Patient Education: Patients and their caregivers will receive education on signs of complications, proper catheter and stent care, and when to seek medical attention.

How is PTBD Externo Internalisation Performed?

PTBD Externo Internalisation is a procedural intervention involving an initial percutaneous transhepatic biliary drainage (PTBD) with external drainage, followed by internalization through the placement of a stent. The procedure is typically performed in a specialized interventional radiology suite and involves several key steps:

  • Patient Preparation: Before the procedure, the patient undergoes a comprehensive evaluation, including a review of medical history, physical examination, and diagnostic imaging studies such as ultrasound or CT scans. The patient is positioned on the procedure table, and the skin overlying the targeted area is cleaned and sterilized.
  • External Drainage Phase: The PTBD procedure begins with inserting a catheter externally through the liver parenchyma into the biliary system. This external drainage phase allows for controlled bile diversion, addressing symptoms and complications associated with biliary leaks or obstructions.
  • Anesthesia: PTBD Externo Internalisation is typically performed under local anesthesia with sedation. This ensures that the patient is comfortable and pain-free during the procedure.
  • Image Guidance: Real-time imaging techniques, such as fluoroscopy or ultrasound, guide the procedure. These imaging modalities help the interventional radiologist visualize the anatomy, locate the biliary system, and guide the catheter insertion accurately during both the external drainage and internalization phases.
  • Catheter Internalization: After an initial period of external drainage, the catheter is internalized through the placement of a stent. The stent creates a stable conduit within the biliary system, allowing for ongoing internal drainage without needing an external collection system.
  • Confirmation and Adjustments: Imaging confirms the internalization process, ensuring proper stent placement and effective internal drainage. Adjustments may be made to optimize positioning and function.
  • Closure and Dressing: The incision site from the external drainage phase is closed with sutures or adhesive dressings. Sterile dressings are applied to the catheter exit site to prevent infection.
  • Post-procedural Monitoring: The patient is monitored closely in a recovery area immediately following the procedure. Vital signs are observed, and any immediate post-procedural issues are addressed.

Leading Hospitals for PTBD Externo Internalisation in India

Doctors for PTBD Externo Internalisation in India

Author

Dr. Deepanshu Siwach

Doctor of Pharmacy
Dr. Deepanshu Siwach is a skilled clinical pharmacist with a Doctor of Pharmacy degree. He has 4+ years of experience and has worked with thousands of patients. He has been associated with some of the top hospitals, such as Artemis Gurgaon and Teerthanker

View Profile

Dr. Deepanshu Siwach is a skilled clinical pharmacist with a Doctor of Pharmacy degree. He has 4+ years of experience and has worked with thousands of patients. He has been associated with some of the top hospitals, such as Artemis Gurgaon and Teerthanker...

Reviewer

Dr. Ajitabh Srivastava

Director
Hepatologist, Liver Transplant Surgeons, Surgical Gastroenterologists

Aakash Healthcare Super Speciality Hospital, Dwarka, New Delhi

Dr. Ajitabh Srivastava is one of the best Hepatologists, Surgical Gastroenterologists, and Liver Transplant Surgeons in New Delhi. With over 26 years of experience, he has performed over 2500 liver transplant procedures. He specializes in hepato-pancreato-biliary (HPB) surgery, gastrointestinal surgery, acute liver failure treatment, laparoscopic surgery, and gall bladder surgery....

Frequently Asked Questions

Alternatives to PTBD Externo Internalisation may include endoscopic interventions like ERCP, surgical options, or internal stenting without initial external drainage. The choice depends on the specific biliary condition and patient characteristics. The healthcare team determines the most suitable approach based on individual needs and treatment goals.

Following PTBD Externo Internalisation, lifestyle changes may include careful catheter and stent care, adherence to any dietary recommendations, and attending regular follow-up appointments. Patients should avoid activities that could compromise catheter or stent integrity and follow healthcare provider guidelines for optimal recovery and ongoing biliary management.

The duration of PTBD Externo Internalisation can vary based on the specific biliary condition and treatment plan. The procedure, including external drainage and internalization, typically lasts 60 to 90 minutes. However, the overall duration of the intervention and subsequent internal drainage may extend over weeks to address specific patient needs.

The time to return to normal activities after PTBD Externo Internalisation varies among individuals. Generally, patients may resume normal activities gradually within a few days to a week. Still, the timeline depends on factors such as overall health, recovery progress, and post-procedural recommendations from healthcare providers.

The success rate of PTBD Externo Internalisation is generally high. Successful catheter placement, effective biliary drainage, and smooth internalization through stent placement are often achieved. Success rates may vary based on the complexity of the biliary condition and the medical team's expertise.

The duration of PTBD Externo Internalisation varies but typically takes about 60 to 90 minutes. The actual time may depend on factors such as the complexity of the biliary condition, the patient's anatomy, and any additional considerations during the internalization phase of the procedure.

Blogs

The Art of Effective Communication