Clnical Analysis Of Clonorchiasis And Cholestatic Jaundice

Objective:To analyse the clinical features and to evaluate the efficacy and safety of drug therapy, endoscopic retrograde cholangiopancreatography (ERCP) treatment and surgical treatment on patients with clonorchiasis and cholestatic jaundice, and how to choose the appropriate treatment.Methods:This study was designed to retrograde analysis of143cases of patients with clonorchiasis and cholestatic jaundice and were divided according to clinical conditions into:medicine alone (n=92), combination with endoscopy(n=26) and surgery(n=25). Medical group were treated with liver supportive and jaundice eliminating drugs. Endoscopic group was treated with ERCP and associated techniques. Surgical group was treated with laparotomy.Results:121of143cases had concomitant disease, and the most common concomitant diseases were cholelithiasis(30.70%), viral hepatitis(23.08%), cirrhosis(17.48%). The misdiagosis rate was2.10%(3/143) in our study. The effective rates of medical group, endoscopic group and surgical group was73.91%(68/92),92.31%(24/26),84.00%(21/25) respectively within four weeks treatment, the difference was not significant. The median hospital stays of medical group, endoscopic group and surgical group were17,23and28days respectively, which were statistically significant (P<0.05), and also there were statistical significances (P<0.05) in pairwise comparisons using SNK test. The incidences of complications were5.3%(5/92),19.23%(5/26),16.00%(4/25) respectively among the three groups, and was statistically significant (P<0.05), however, there was no statistical difference (P>0.0167) in pairwise comparison using exact probabilities in2×2table with the new level of0.0167(a’) according to Bonferroni.Conclusion:The patients with clonorchisis sinensis and cholestatic jaundice excluding carcinoma, calculus and stricture of bile duct, medical treatment could give rise a good result; the endoscopic treatment is a safe and effective treatment measure which caused smaller trauma and shorter hospital-stay in relieving obstruction for clonorchisis sinensis and obstruction juadice.Thus ERCP should be a preferred treatment unless there are coexisting huge stones, cholangiocarcinoma which can’t be sure to make radical resection or highly suspected tumor needing surgical treatment.