Pre-Procedure Risk Stratification and Outcomes After Percutaneous Transhepatic Biliary Drainage for Malignant Obstruction: A Prospective Single-Centre Study

Abstract Recent studies have identified multiple factors associated with increased mortality and morbidity in patients undergoing percutaneous biliary interventions. Although several risk stratification scales have demonstrated value in identifying high-risk patients, evidence remains limited for populations with advanced frailty and short life expectancy, where quality of life is a primary concern. This observational study aimed to replicate previously reported results using a risk stratification scale and explore additional risk factors associated with outcomes. Thirty-seven patients were assessed before the procedure using the Eastern Cooperative Oncology Group (ECOG) scale and a predefined scoring system. Mortality at 7, 30, and 90 days was determined through national registry data. While we were unable to reproduce previously published favourable results using the modified risk scale, the ECOG score was confirmed as an independent predictor of 30-day mortality ( p = 0.028). Infectious complications were common after percutaneous biliary drainage (PBD), and antibiotic prophylaxis did not influence short-term mortality. Individualised pre-procedural risk assessment is recommended for oncology patients undergoing PBD with palliative intent.