Comparative Study Between Surgical Drainage And Endoscope Retrograde Biliary Stenting On Low Biliary Obstruction With Malignancy

Objective To compare the different effect of low malignant biliary obstructionbetween traditional surgical internal drainage and endoscopic retrograde biliarydrainage（ERBD）.Methods Review all the97cases of low malignant biliary obstruction whichwere performed respectively in the traditional surgical drainage and ERBD in May2006to March2011in Ningxia medical university hospital. All the cases weredivided into two groups, one group used stent placement in the biliary intervention(ERBD) reduce the palliative yellow repair group, and the other used braverymanager or gallbladder jejunum Roux-Y art; Major postoperative T tube in thesurgical drainage bridge in drainage group, monitoring of two groups ofpreoperative1~3days, postoperative1to3days, the first weeks of ALT, AST,IBIL, TBIL, DBIL, GGT, the AKP than that of preoperative reduce degree, andtwo sets of patients in hospital length of hospital stay, cost, survival time,totalpostoperative complications, surgery applicable scope, through the statisticalanalysis of the differences between the two groups were significantly.Result47out of50cases treated by ERBD were successful, the rate of technicalsuccessful is94%, two cases of concurrent pancreatitis, complication rate was4%;44out of47cases treated by traditional surgical drainage were successful, the rateof technical successful is93.6%, one case appeared gastrointestinal bleeding,1 case with pancreatitis and1case of postoperative infection, complication rate was6.3%. The X~2and t inspection shows that two groups of patients incidence rate ofpostoperative complications are not significant (P>0.05), two groups of patientspostoperative1to3days, the first week of ALT, AST, IBIL, TBIL, DBIL, GGT,the AKP than that of preoperative1~3days has dropped significantly, but twosets down comparison between the degree is no statistical difference (P>0.05),and ERBD group average length of hospital stay, and were significantly less thanthe average hospital expenses drainage of the surgery, and the differences arestatistically significant (P <0.05), underlying medical conditions of low inpatients with malignant obstructive jaundice, ERBD was a total of21patientsgroup, a ratio of42%, and in the traditional surgical drainage group have fivepatients, the proportion is10.6%, the chi-square test two groups of comparisonsare statistically significant difference (P <0.05).Conclusion ERBD with its small trauma, widely used, short time of cure period,low expenses, quick recovery, drainage way of physiological condition moreapproximate provides an alternativeway for treatment.