Difference Between ERCP And PTBD In The Treatment Of Hepatic Alveolar Echinococcosis Complicated With Obstructive Jaundice

Objective: By comparing the curative effect of ERCP or PTBD for preoperative jaundice reduction in patients with HAE complicated with obstructive jaundice,the advantages and disadvantages of ERCP and PTBD in the treatment of hepatic alveolar echinococcosis complicated with obstructive jaundice before surgery were discussed,and the reference basis for clinical diagnosis and treatment was provided.Methods: The patients’ information with hepatic alveolar echinococcosis who were treated in the First Affiliated Hospital of Xinjiang Medical University from January 1,2016 to May 31,2022 were collected,and the qualified cases were screened according to the inclusion and exclusion criteria,and the jaudice reduction effect,complication rate and success rate of the ERCP group and PTBD group were compared.Results: 1.A total of 3202 cases were collected,of which 44 cases were qualified including 15 cases in ERCP group and 29 cases in PTBD group.There was no statistical difference between the two groups in terms of gender,age,ethnic group,height,weight,HBV and HCV infection,lesion size,PNM stage and other indicators(P > 0.05);2.In ERCP group,there was no statistically significant difference in liver function related indexes such as ALT,AST,ALB,GGT,ALP and coagulation indexes such as APTT and PT before and after surgery(P>0.05);3.ALP and GGT in PTBD group decreased significantly after surgery(P<0.01),APTT and ALB in PTBD group also decreased after surgery(P<0.01).The changes of other indicators were not statistically significant(P>0.05);4.In terms of postoperative complications,there was no bleeding in both groups,but the incidence of postoperative complications in PTBD group was higher than that in ERCP group and drainage tube obstruction was the main complication in PTBD group(P>0.05);5.There was no significant difference in the success rate of jaudice reduction between ERCP group and PTBD group,but there were operation failures and reoperations in ERCP group,the success rate of ERCP surgery was 76.47%,while the operation success rate in PTBD group was 100%,which showed that the operation failure rate in ERCP group was higher than that in PTBD group;6.Preoperative complication category,preoperative ALB,preoperative PT,and nationality have no significant impact on the incidence of postoperative complications and the success rate of jaudice reduction(P>0.05),but postoperative complications will reduce the success rate of jaudice reduction(P<0.01).Conclusion: 1.Both PTBD and ERCP are effective means to reduce jaundice for hepatic alveolar echinococcosis complicated with jaundice.ERCP has more advantages for patients with ascites and poor coagulation function.2.ERCP is difficult to operate and has a high failure rate,but it is internal drainage and should be actively tried.If ERCP fails,PTBD should be performed as soon as possible.3.PTBD is easy to operate,but it is easy to have complications such as drainage tube blockage,detachment and biliary system infection after operation,with high risk.