| Objective:The aim of this study was to retrospectively analyze and compare the effectiveness of3commonly used palliative biliary drainage procedures for the patients with malignant obstructive jaundice in our hospital.Methods:We collected322cases of advanced malignant obstructive jaundice, which were enrolled in our hospital from June2005to June2009. According to their imaging and laparotomy results, none of them was suitable for radical resection and some palliative treatments were performed alternatively, including cholecystojejunostomy, operative bypass (n=123), percutaneous transhepatic cholangial drainage (PTCD, n=114) and endoscopic retrograde cholangiopancreatography (ERCP, n=95). The hospitalization time, operation time, intraoperative blood loss, hospitalization cost, jaundice reducing effects, recovery of liver function, operative mortality, incidence of complications, long-term life quality and survival time of patients were compared.Results:In our study,322cases were collected,257cases were successfully followed up and the follow-up rate was77.41%. In all the follow-up cases, there were95cases performed with cholecystojejunostomy, operative bypass,89cases with ERCP and73cases with PTCD. There was no significant difference of the follow-up rates among these3groups. Compared with cholangioenterostomy, ERCP group had shorter hospital stay and less short-term complications, while no significant differences were found in jaundice reducing effects, life quality and survival time. Compared with the group of cholangioenterostomy operative bypass, PTCD group had shorter hospital stay, lower medical expenses and less short-term complications, while there were no significant difference in jaundice reducing effects, life quality and survival time.Conclusion:ERCP has the advantages of wide range of indications, minimally invasive and less expense. It was the first choice for the patients of advanced malignant obstructive jaundice and PTCD was the second. |
PDF Full Text Request