{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:04:07Z","timestamp":1789643047396,"version":"4.0.0"},"reference-count":26,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002583","name":"Gyeongsang National University","doi-asserted-by":"publisher","award":["GNU-NFRSG-0025"],"award-info":[{"award-number":["GNU-NFRSG-0025"]}],"id":[{"id":"10.13039\/501100002583","id-type":"DOI","asserted-by":"publisher"}]},{"award":["GNU-NFRSG-0025"],"award-info":[{"award-number":["GNU-NFRSG-0025"]}],"id":[{"id":"https:\/\/ror.org\/00saywf64","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: No current guideline specifies the timing of catheter removal after percutaneous transhepatic biliary drainage (PTBD). This study aimed to evaluate the clinical outcomes of early PTBD catheter removal after resolution of biliary obstruction in patients with acute cholangitis. Methods: This retrospective, single-center cohort study included 357 patients with acute cholangitis who underwent PTBD. Patients were divided into an early removal group (7\u201310 days, n = 199) and a late removal group (&gt;10 days, n = 158) according to the timing of PTBD catheter removal. Clinical outcomes after catheter removal were compared between the two groups. Results: There was no significant difference between the two groups in the complication rate after PTBD catheter removal (2.5%; 95% CI, 1.1\u20135.7% in the early group vs. 1.9%; 95% CI, 0.6\u20135.4% in the late group; p &gt; 0.999). In the early group, the most common complication was biloma (n = 3, 1.5%), followed by bile peritonitis (n = 1, 0.5%) and hemobilia (n = 1, 0.5%). In the late removal group, biloma, bile peritonitis, and hemobilia each occurred in one patient (0.6%). The total length of hospital stay was significantly shorter in the early group than in the late group (12 days [IQR, 10\u201315] vs. 17 days [IQR, 14\u201324]; p &lt; 0.001). In exploratory multivariable analysis, early removal was associated with a 5.36-day shorter adjusted conditional median hospital stay than late removal (95% CI, 3.63\u20137.08; p &lt; 0.001). Conclusions: Early PTBD catheter removal 7\u201310 days after placement appears to be feasible and was associated with a low rate of post-removal complications in appropriately selected patients with acute cholangitis, provided that predefined removal criteria are met.<\/jats:p>","DOI":"10.3390\/jcm15187219","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:59:03Z","timestamp":1789639143000},"page":"7219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Safety of Early Catheter Removal After Percutaneous Transhepatic Biliary Drainage in Acute Cholangitis: A Retrospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2570-6643","authenticated-orcid":false,"given":"Jae Min","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0376-0316","authenticated-orcid":false,"given":"Hyeon Uk","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4133-8791","authenticated-orcid":false,"given":"Jung Woo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-1646","authenticated-orcid":false,"given":"Ji Hee","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Ji Yoon","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Ra Ri","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1029-3436","authenticated-orcid":false,"given":"Sang Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7798-6491","authenticated-orcid":false,"given":"Hankyu","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon 51472, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4016-4443","authenticated-orcid":false,"given":"Ok Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.jviscsurg.2019.05.007","article-title":"Acute cholangitis: Diagnosis and management","volume":"156","author":"Sokal","year":"2019","journal-title":"J. Visc. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/ans.13981","article-title":"Acute cholangitis: Current concepts","volume":"87","author":"Christophi","year":"2017","journal-title":"ANZ J. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.suc.2018.11.002","article-title":"Cholangitis: Causes, Diagnosis, and Management","volume":"99","author":"Sulzer","year":"2019","journal-title":"Surg. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6551","DOI":"10.3748\/wjg.v12.i40.6551","article-title":"Endoscopic management of acute cholangitis in elderly patients","volume":"12","author":"Agarwal","year":"2006","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4291\/wjgp.v9.i1.1","article-title":"Acute cholangitis\u2014An update","volume":"9","author":"Ahmed","year":"2018","journal-title":"World J. Gastrointest. Pathophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/den.12848","article-title":"Endoscopic management of acute cholangitis as a result of common bile duct stones","volume":"29","author":"Ramchandani","year":"2017","journal-title":"Dig. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.gie.2019.09.040","article-title":"Emergent versus urgent ERCP in acute cholangitis: A systematic review and meta-analysis","volume":"91","author":"Iqbal","year":"2020","journal-title":"Gastrointest. Endosc."},{"key":"ref_8","first-page":"103","article-title":"Diagnosis and management of bile stone disease and its complications","volume":"62","author":"Cremer","year":"2016","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kim, M.U., Lee, Y., Lee, J.H., Cho, S.B., Lee, M.S., So, Y.H., and Choi, Y.H. (2021). Predictive factors affecting percutaneous drainage duration in the percutaneous treatment of common bile duct stones. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248003"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/S0016-5107(00)70441-X","article-title":"Percutaneous treatment of bile duct stones in patients treated unsuccessfully with endoscopic retrograde procedures","volume":"51","author":"Berger","year":"2000","journal-title":"Gastrointest. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.gie.2016.12.023","article-title":"Efficacy and safety of EUS-guided biliary drainage in comparison with percutaneous biliary drainage when ERCP fails: A systematic review and meta-analysis","volume":"85","author":"Sharaiha","year":"2017","journal-title":"Gastrointest. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1097\/MCG.0000000000000275","article-title":"Drainage-related Complications in Percutaneous Transhepatic Biliary Drainage: An Analysis over 10 Years","volume":"49","author":"Nennstiel","year":"2015","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.ejrad.2008.08.012","article-title":"Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts","volume":"72","author":"Weber","year":"2009","journal-title":"Eur. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40644-017-0129-1","article-title":"Comparison of efficacy and complications of endoscopic and percutaneous biliary drainage in malignant obstructive jaundice: A systematic review and meta-analysis","volume":"17","author":"Duan","year":"2017","journal-title":"Cancer Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/jhbp.519","article-title":"Tokyo Guidelines 2018: Management bundles for acute cholangitis and cholecystitis","volume":"25","author":"Mayumi","year":"2018","journal-title":"J. Hepato-Biliary-Pancreat. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/SLE.0000000000000761","article-title":"Safety and Efficacy of Early Tube Removal Following Percutaneous Transhepatic Gallbladder Drainage: An Observational Study","volume":"30","author":"Kamezaki","year":"2020","journal-title":"Surg. Laparosc. Endosc. Percutan. Tech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/jhbp.512","article-title":"Tokyo Guidelines 2018: Diagnostic criteria and severity grading of acute cholangitis (with videos)","volume":"25","author":"Kiriyama","year":"2018","journal-title":"J. Hepato-Biliary-Pancreat. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1378\/chest.101.6.1644","article-title":"Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis","volume":"101","author":"Bone","year":"1992","journal-title":"Chest"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1055\/s-0041-1731375","article-title":"Complications of Percutaneous Biliary Procedures","volume":"38","author":"Molina","year":"2021","journal-title":"Semin. Interv. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0895-4356(94)90129-5","article-title":"Validation of a combined comorbidity index","volume":"47","author":"Charlson","year":"1994","journal-title":"J. Clin. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s002709900208","article-title":"Maturation of the tract after percutaneous cholecystostomy with regard to the access route","volume":"21","author":"Hatjidakis","year":"1998","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3338","DOI":"10.1007\/s00261-021-03207-4","article-title":"Complications of percutaneous transhepatic cholangiography and biliary drainage, a multicenter observational study","volume":"47","author":"Turan","year":"2022","journal-title":"Abdom. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/1457496917731192","article-title":"Palliation of Malignant Biliary Obstruction: Adverse Events are Common after Percutaneous Transhepatic Biliary Drainage","volume":"107","author":"Heedman","year":"2018","journal-title":"Scand. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kokas, B., Szijarto, A., Farkas, N., Ujvary, M., Mori, S., Kalocsai, A., and Szucs, A. (2021). Percutaneous transhepatic drainage is safe and effective in biliary obstruction-A single-center experience of 599 patients. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0260223"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2333721417739188","DOI":"10.1177\/2333721417739188","article-title":"Factors Related to the Severity of Delirium in the Elderly Patients with Infection","volume":"3","author":"Kuswardhani","year":"2017","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Magny, E., Le Petitcorps, H., Pociumban, M., Bouksani-Kacher, Z., Pautas, E., Belmin, J., Bastuji-Garin, S., and Lafuente-Lafuente, C. (2018). Predisposing and precipitating factors for delirium in community-dwelling older adults admitted to hospital with this condition: A prospective case series. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193034"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7219\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:44:22Z","timestamp":1789641862000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":26,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187219"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187219","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}