Comparison The Efficacy Of PTBD And ERCP In The Treatment Of HAE With Obstructive Jaundice

Objective : Comparison between the efficacy of PTBD and ERCP in the treatment of hepatic alveolar echinococcosis with obstructive jaundice.Through researching the advantages of PTBD and ERCP in the treatment of HAE with obstructive jaundice,Provide reference for Clinical select a better way to relieve the late HAE patients with jaundice obstructive.Methods : Through researching the advantages of PTBD and ERCP in the treatment of HAE with obstructive jaundice,Provide reference for Clinical select a better way to relieve the late HAE patients with jaundice obstructive.Results:1.A total of 1189 cases were collected,41 cases meet the inclusion and exclusion criteria,Line PTBD treatment in 23 cases,Line ERCP treatment in 18 cases.There were no differences in age,sex,ethnic,hydatidella,HBV infection,lesion location,lesion size,obstruction site,lesion necrosis,N stage,M stage,preoperative operation history,preoperative liver function classification and so on(P>0.05).PTBD group more than preoperative jaundice more than ERCP patients,Lesion calcification and P1,P2 in patients with ERCP group than PTBD group(P<0.05).2.The general condition of the patients was better than that of the PTBD group and the ERCP group.The levels of TBIL,DBIL,TBA,γ-GT and ALP in jaundice were significantly lower than those before operation(P<0.05).PTBD group and ERCP group compared with postoperative TBIL decreased more obvious(P<0.05).3.There were no significant differences in ALT,AST,CHE,ALB,PT,APTT,PLT between the two groups(P>0.05).4.Comparison of jaundice at admission and at discharge,PTBD group and ERCP group were decreased TBIL levels,differences were statistically significant(P<0.01).At the time of admission and at the time of discharge,the liver function Child scores were compared,PTBD group difference was statistically significant(P<0.05),ERCP group was not statistically significant(P>0.05).5.Preoperative ALB levels are protective factors affecting the degree of preoperative jaundice in patients with HAE(P<0.05,OR<1).6.Cholecystitis,preoperative ALB,preoperative PLT is a protective factor in HAE patients with postoperative complications(P<0.05,OR<1),Lesions M staging are the protective factors that affect the prognosis of patients with HAE(P<0.05,OR<1).7.The cost of treatment in PTBD group was lower than that in ERCP group(P<0.05).But thetotal cost of hospitalization between the two groups was not statistically significant(P>0.05).8.There was no statistically significant difference between the two groups in postoperative complications and prognosis(P>0.05).Conclusions: Both PTBD and ERCP were effective in reducing the levels of bilirubin and obstructive jaundice-related liver function in patients with HAE,Improve the general situation of patients,And PTBD group than ERCP patients with bilirubin levels decreased more significantly,But both did not significantly improve other liver function indicators.PTBD and ERCP may not differ in postoperative complications and prognosis,PTBD compared to ERCP simple operation,the lower the cost of treatment,the total cost of both hospital no difference.