Evaluation Of Curative Effect Of Three Kinds Of Palliative Therapy In The Treatment Of Malignant Biliary Obstruction

BackgroundMalignant biliary obstruction refers to tumor compression or invasion of extrahepatic bile duct,biliary stricture caused by biliary excretion,resulting in disruption.Mainly for jaundice,abdominal pain,fever and secondary deterioration of liver function,severe sepsis can occur,liver and kidney failure,abnormal blood coagulation,the mortality rate is very high.If you do not take timely treatment,the prognosis is poor,the average survival period of less than 3 months of.92% patients died within six months.The rate of radical resection of lower surgery,palliative biliary drainage is an effective way to reduce jaundice.The clinical commonly used palliative treatment with surgery,endoscopic stent,percutaneous transhepatic biliary drainage.In recent years,research on the efficacy and safety of different drainage methods has become a hot research topic.ObjectiveThrough retrospective analysis of our hospital underwent palliative biliary intestinal anastomosis,endoscopic drainage(ERCP),percutaneous transhepatic biliary drainage(PTCD)clinical data of different methods,to evaluate the clinical features and advantages and disadvantages,and provide reference for clinicians.MethodDuring the period from May 2011 to July 2015 in our hospital for patients with malignant biliary obstruction failed to radical resection in 193 cases,according to endoscopic biliary stent implantation,percutaneous transhepatic biliary drainage and palliative biliary enteric anastomosis and three treatment methods were divided into ERCP group,PTCD group and choledochojejunostomy group,three groups of patients with liver function,complications,hospitalization time and survival time were analyzed retrospectively.Result1.In general,there was no significant difference in the ratio of male to female,average age and incidence of each group(P > 0.05).The data of the three groups were comparable.2.In the treatment of malignant biliary obstruction symptoms,skin and yellow sclera is most common,followed by fatigue,abdominal pain,chills and fever,basically accord with the literature.3.In the treatment effect,three groups of patients with ALT,TBIL,ALP,GGT after operation were significantly decreased compared with the preoperative,the difference was statistically significant(P<0.05).There was no significant difference between the groups decreased after operation(P>0.05).Postoperative follow-up by comparison,the average survival time of three groups of patients there was no significant difference(P>0.05).4.The complication rate in ERCP group compared with PTCD group and choledochojejunostomy group decreased significantly,the difference was statistically significant(P<0.05).In PTCD group than choledochojejunostomy group postoperative complications decreased,the difference was statistically significant(P<0.05).5.The average length of stay in the ERCP group and the PTCD group was shorter than that in the group of biliary anastomosis,and the difference was statistically significant(P<0.05).There was no significant difference between the ERCP group and the PTCD group(P>0.05).ConclusionERCP,PTCD,and biliary anastomosis can effectively achieve biliary drainage,reduce jaundice,protect liver function and prolong the survival time of patients,which is an effective method for palliative treatment of malignant biliary obstructionCompared with the other two treatments,ERCP has some advantages,and can be popularized in clinic.