Comparison of C-arm CT fluoroscopy and conventional fluoroscopy for percutaneous biliary drainage procedures

PURPOSE: To conduct a prospective randomized evaluation of Carm computed tomography (CT) fluoroscopy for external biliary drainage procedures in comparison with conventional fluoroscopic guidance to reduce the number of transhepatic punctures as a primary endpoint. MATERIALS AND METHODS: In 18 patients with biliary obstructions, 20 external percutaneous biliary drainage procedures were prospectively performed with use of either C-arm CT fluoroscopy or conventional fluoroscopy alone. The number of hepatic punctures, procedure time, and fluoroscopy time, were analyzed separately for both methods. RESULTS: C-arm CT fluoroscopy resulted in a reduced number of transhepatic punctures, with decreased procedure and fluoroscopy times (P < .05; t test). When compared with conventional external biliary drainage procedures, a mean of 1.8 +/- 1 versus 4.8 +/- 2.8 hepatic punctures at a fluoroscopy time of 3.4 +/- 1.5 versus 11.4 +/- 7.4 minutes was required for C-arm CT fluoroscopy, while procedure times were 11 +/- 3.6 versus 16.2 +/- 9.3 minutes. CONCLUSIONS: C-arm CT fluoroscopy is associated with decreased procedure and fluoroscopy times, while fewer transhepatic punctures are required to establish external biliary drainage.