Intervention Efficacy Analysis Of Malignant Obstructive Jaundice

Objective Investigate the treatment of different types of malignant obstructivejaundice clinical results and value through intervention.Methods To retrospective analysis curative effect of126patients with malignantbiliary obstruction accept the intervention. All patients treat malignant obstructive jaundicethrough percutaneous transhepatic cholangial drainage and percutaneous transhepaticinsertion of biliary stent,167metal stents were implanted（among them92mesh type ofmetal stents were implanted in70patients,75laser engraving type of metal stents wereimplanted in56patients）. The stents were implanted in different parts according to thedifferent types of obstruction,92stents were implanted in the hepatic portal of51patients(41patients were implanted in double stents),41stents were implanted in commonbile duct of51patients,34stents were implanted in ampullary of patients.After the PTIBS,62cases of patients with combined intervention approaches antitumor dual interventionaltherapy. among them57cases were treated through transeatheter arterialchemoembolizafion，after TACE17cases（generally diameter of the tumor less than5cm）were treated through percutaneous radiofrequency ablation，5cases were treated throughpercutaneous tumor drug injection.Results (1)126patients were successfully implanted biliary metal stents andindwelling biliary drainage tube, The successful rate of PTCD+PTIBS is100%(126/126).(2) After PTIBS drainage in patients with serum total bilirubin (TBIL), direct bilirubin(DBIL) and alanine aminotransferase (ALT) as independent samples carried t test, P valueswere less than0.001.(3) The survival time and stents,unobstructed time of the123patients (lost three cases) who were implanted different types of metal biliary stents were followed up, Which implanted mesh type or laser type, the median survival time were179d,186d, the median stents,unobstructed time were182d,196d, the patency rates andsurvival of3,6,9months after surgery were carried chi-square,p values were greaterthan0.05.(4) Postoperative follow-up of different types of MOJ stents patency andsurvival of patients after intervention, were carried statistical analysis, the results showedthat the site of obstruction was no significant difference on stents patency and survival ofpatients.(5) The62patients which after PTIBS combined intervention to anti-tumorcompared with the61patients which merely carried PTIBS,nine-monthsurvival rate were50.0%and13.1%,2=19.319, P=0.000;18-month survival rate were25.8%and6.6%,2=8.367, P=0.004.3,6months stents patency rate comparison p <0.001with a verysignificant difference.Conclusion (1) High success rate of the PTIBS, the treatment of MOJ effect isobvious.(2) The two types of metal biliary stents(mesh type and laser type) for survivaltime of patients and stent patency were no significant difference, the two kinds of stentscan play the same role in some extent.(3) MOJ of different types, no significant differenceafter PTIBS for the stent patency rate and survival time of patients.(4) PTIBS Combineintervention for anti-cancer therapy, prolong the time of patients survival and stentspatency.