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Clinical Performance Status and Technical Factors Affecting Outcomes from Percutaneous Transhepatic Biliary Interventions; A Multicentre, Prospective, Observational Cohort Study

Lookup NU author(s): Dr Colin Nice, Dr Raman Uberoi



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s).Purpose: The purpose of this study was to evaluate the predictive value of a ‘Modified Karnofsky Scoring System’ on outcomes and provide real-world data regarding the UK practice of biliary interventions. Materials and Methods: A prospective multi-centred cohort study was performed. The pre-procedure modified Karnofsky score, the incidence of sepsis, complications, biochemical improvement and mortality were recorded out to 30 days post procedure. Results: A total of 292 patients (248 with malignant lesions) were suitable for inclusion in the study. The overall 7 and 30 day mortality was 3.1% and 16.1%, respectively. The 30 day sepsis rate was 10.3%. In the modified Karnofsky ‘high risk’ group the 7 day mortality was 9.7% versus 0% for the ‘low risk’ group (p = 0.002), whereas the 30 day mortality was 28.8% versus 13.3% (p = 0.003). The incidence of sepsis at 30 days was 19% in the high risk group versus 3.3% at the low risk group (p = 0.001) Conclusion: Percutaneous biliary interventions in the UK are safe and effective. Scoring systems such as the Karnofsky or the modified Karnofsky score hold promise in allowing us to identify high risk groups that will need more careful consideration and enhanced patient informed consent but further research with larger studies is warranted in order to identify their true impact on patient selection and outcomes post biliary interventions.

Publication metadata

Author(s): Makris GC, Macdonald AC, Allouni K, Corrigall H, Tapping CR, Hughes JP, Anthony S, Boardman P, Patel R, Wigham A, Husainy MA, See TC, Cast J, Olliff S, Travis S, Laasch H-U, Nice C, Uberoi R

Publication type: Article

Publication status: Published

Journal: CardioVascular and Interventional Radiology

Year: 2021

Volume: 44

Pages: 1625-1632

Print publication date: 01/10/2021

Online publication date: 12/07/2021

Acceptance date: 28/05/2021

Date deposited: 10/08/2021

ISSN (print): 0174-1551

ISSN (electronic): 1432-086X

Publisher: Springer


DOI: 10.1007/s00270-021-02888-0


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Funder referenceFunder name
This study was funded by the British Society of Interventional Radiology.