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PTBD Internalisation Treatment Cost in India

  • Starting From: USD 400 - USD 1000

  • Hospitalization Days: 2 -3 Days

  • Procedure Duration: 1 Hrs - 2 Hrs

How Much Does PTBD Internalisation Treatment Cost in India?

PTBD Internalisation is affordable in India. The cost of PTBD Internalisation in India lies between USD 400 - USD 1000. The exact procedure price depends on multiple factors such as the surgeon's experience, type of hospital, severity of the condition, patient's general condition,etc.

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Percutaneous Transhepatic Biliary Drainage Internalisation, or PTBD Internalisation, is a medical procedure to manage complex biliary leaks or obstructions. This technique involves an initial percutaneous transhepatic biliary drainage (PTBD) with external catheter placement. Subsequently, the drainage route is internalized through the insertion of a stent. PTBD Internalisation aims to transition from external to internal drainage, optimizing the effectiveness of biliary drainage while minimizing invasiveness. This tailored approach is performed in an interventional radiology setting, offering a less invasive alternative to traditional surgical interventions for specific biliary conditions, ultimately contributing to improved patient outcomes.

Why Do You Need PTBD Internalisation?

PTBD Internalisation is employed for specific clinical scenarios where percutaneous transhepatic biliary drainage (PTBD) with external drainage is initially performed, followed by the internalization of the drainage route through the placement of a stent. Here are key reasons for opting for PTBD Internalisation:

  • Complex Biliary Leaks or Obstructions: PTBD Internalisation is particularly beneficial in managing complex biliary leaks or obstructions. The initial external drainage phase allows symptom relief and controlled bile diversion, while the subsequent internalization through a stent provides ongoing, stable drainage.
  • Transition to Internal Drainage: The procedure facilitates a controlled transition from external to internal drainage. After an initial period of external drainage, internalization through a stent creates a stable conduit, eliminating the need for an external catheter.
  • Minimally Invasive Nature: PTBD Internalisation is considered a minimally invasive approach compared to traditional surgical interventions. It is typically performed in an interventional radiology setting, leading to reduced 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.
  • Tailored Patient Care: PTBD 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 Internalisation

Percutaneous Transhepatic Biliary Drainage (PTBD) Internalisation involves transitioning from an initial external drainage to internal drainage through the placement of a stent. Different stents and internalization approaches can be utilized based on the clinical context. Here are common types:

  • Single Stent Internalisation: This involves placing a single stent to internalize the drainage route. The single stent provides a stable conduit for ongoing internal drainage, addressing complex biliary leaks or obstructions.
  • Double Stent Internalisation: In some cases, two stents may be used during internalization. This approach may address specific anatomical considerations or provide additional support and stability to the drainage pathway.
  • Covered Stent Internalisation: A covered stent may be utilized to internalize the drainage route. Covered stents fully encase the drainage pathway, preventing bile leakage and promoting a more controlled internal drainage.
  • Bilateral Internalisation: Internalisation 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 Percutaneous Transhepatic Biliary Drainage (PTBD) Internalisation involves a thorough evaluation by a multidisciplinary healthcare team. Key factors contribute to the decision-making process:

  • Diagnostic Assessments: Patients undergo comprehensive diagnostic evaluations, including imaging studies like ultrasound, CT scans, or MRCP. These tests help identify the nature and extent of biliary leaks or obstructions, guiding the decision to proceed with PTBD Internalisation.
  • Clinical Presentation: The severity of symptoms and clinical presentation play a crucial role in patient selection. PTBD Internalisation is often considered for individuals experiencing complex biliary leaks, obstructions, or complications that necessitate 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 Internalisation is made collaboratively with a multidisciplinary team, including gastroenterologists, interventional radiologists, and surgeons. This collaborative approach ensures a comprehensive evaluation and a well-rounded strategy for patient care.
  • Treatment Goals: The appropriateness of PTBD Internalisation is determined based on specific treatment goals. This may include addressing biliary leaks, obstructions, or other conditions that warrant drainage and internalization.
  • Patient Consent: Informed consent is obtained from the patient before the procedure. This involves explaining the purpose of PTBD Internalisation, potential risks, benefits, and alternative treatment options, allowing patients to make informed decisions about their care.

Risks and Benefits Associated with the Chosen PTBD Internalisation.

Benefits of PTBD Internalisation:

  • Comprehensive Biliary Drainage: PTBD Internalisation provides a comprehensive solution for biliary drainage. The initial external drainage phase allows symptom relief and controlled bile diversion, while the subsequent internalization through a stent provides ongoing, stable drainage.
  • Minimally Invasive Nature: PTBD 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: Internalisation 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 Internalisation:

  • Infection: There is a risk of infection associated with both the external drainage and internalization phases. 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 may occur during the initial phase of external drainage, impacting the procedure's effectiveness. Proper catheter care and patient education are essential to mitigate this risk.

PTBD 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 Internalisation is made based on a thorough assessment of the patient's condition and treatment goals.

What to Expect After a PTBD Internalisation?

After undergoing Percutaneous Transhepatic Biliary Drainage (PTBD) 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 Internalisation, patients are closely monitored in a recovery area. Vital signs are observed, and immediate post-procedural discomfort or complications are promptly addressed.
  • Pain Management: Patients may experience 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 and Stent Care Instructions: Patients receive detailed instructions on caring for the internalized stent and any 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: The external catheter is typically removed during the early post-procedural phase as the internal drainage through the stent stabilizes. The transition from external to internal drainage is a key aspect of the recovery process.
  • 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 as needed to address any 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 stent care, and when to seek medical attention.

How is PTBD Internalisation Performed?

Percutaneous Transhepatic Biliary Drainage (PTBD) Internalisation is a procedural intervention to manage complex biliary leaks or obstructions. The process involves transitioning from initial external drainage to internal drainage by placing a stent. Here are the key steps in the PTBD Internalisation procedure:

  • Patient Preparation: Before the procedure, the patient undergoes a thorough evaluation, including a medical history review and diagnostic imaging studies. The patient is positioned on the procedure table, and the skin overlying the targeted area is cleaned and sterilized.
  • External Drainage Phase: The 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 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 Internalisation: 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 catheter.
  • 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.

Doctors for PTBD Internalisation in India

Author

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

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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

Director
Hepatologist, HPB and Liver Transplant Surgeon, Surgical Gastroenterologist

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

The duration of PTBD Internalisation typically ranges from 60 to 90 minutes. However, the actual time may vary based 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.

The success rate of PTBD 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 time to return to normal activities after PTBD Internalisation varies. 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 duration of PTBD 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.

Lifestyle changes after PTBD Internalisation may include attentive catheter and stent care, adherence to dietary recommendations, and 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.

Alternative treatments for PTBD 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.

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