Title: Dual Technique Percutaneous Nephrostomy: Experience from a Tertiary Care Centre

Authors: Suprava Naik, MD, Hira Lal, MD, Bharat Gupta, MD, Pragati Verma, MD

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.185

Abstract

Aim: To review the feasibility and performance of percutaneous nephrostomy (PCN) in a tertiary care teaching hospital and determine the success and complication rate and to compare it with the standard recommended by ACR-SIR-SPR guidelines.

Materials and Methods: We retrospectively reviewed 444 percutaneous nephrostomy in 344 patients performed from January 2010 to December 2012. All PCN performed in native kidney. Prophylactic antibiotic was given to all patients. Patients having coagulation abnormalities were corrected before the procedure. All cases had been carried out by experienced radiologists using a Seldinger technique under ultrasonography and fluoroscopy guidance. Percutaneous nephrostomy was considered successful if the catheter was placed in the pelvis and drained urine or the content of pelvicalyceal system. Indication, success rate and complication rate were noted.

Results: Most common indication was obstructive hydronephrosis (79.3%) due to various causes. Overall success rate was 98%; it was 98.2% for dilated system and 88.9% for non dilated system. Total complication rate was noted in 66 (14.9%) PCN, out of which 40 (9.01%) procedure related and 26 (5.9%) catheter related. Major complications were noted in 9 (2.03%).

Conclusion: Percutaneous nephrostomy using Seldinger technique under both ultrasonography and fluoroscopy guidance in the hands of experienced radiologists is a safe and effective minimally invasive procedure with high success rate and low rate of complications.

Keywords: Percutaneous nephrostomy, Seldinger technique, ultrasonography, fluoroscopy, pelvicalyceal system.

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