Treatment Of Obstructive J Aundice By Metastatic Gastric Cancer

Background:Gastric cancer is one of the most common causes of cancer deaths worldwide.Gastric cancer can result in peritoneum implanting, liver metastases, lymph node metastases, local recurrence,causing a variety of clinical manifestations.We need appropriate treatments to alleviate the symptoms.Obstructive jaundice caused by local recurrence of gastric cancer is very common,these patients have tumors in end-stage,they are difficult to treat and have short survival period. Metastatic gastric cancer is a clinical challenge. Chemotherapy can no longer be considered because of obstructive jaundice caused by metastatic gastric cancer. Surgery,metal stent placement, percutaneous transhepatic cholangial drainage, medicine therapy are commonly used treatments. Percutaneous transhepatic cholangial drainage is a therapy that X-ray or ultrasound-guided, using a special needle penetrating s intrahepatic bile duct, and then inject contrast agent directly into the biliary system to develop the intrahepatic and extrahepatic bile duct, the tube is preserved to drainage bile.Pruritus, fever jaundice, abdominal pain, and general fatigueimproved are significantly improved after percutaneous transhepatic cholangial drainage.Now percutaneous transhepatic cholangial drainage has become one of the palliative methods to treat obstructive jaundice by metastatic gastric cancer. Methods:The clinical outcome of malignant biliary obstruction caused by metastatic gastric cancer remains unclear. This study was designed to evaluate the clinical outcome in patients who underwent percutaneous transhepatic cholangial drainage(PTCD) for malignant biliary obstruction caused by metastatic gastric cancer.Objectives:Total of24patients admitted from2007to2014with malignant biliary obstruction caused by metastatic gastric cancer were retrospectively analyzed,19of these cases were male and5were female.These patients admitted PTCD.We analyse disease history,General information,clinical manifestation,level of bilirubin and the improvement of clinical manifestation.Results:All the24patients accept treatment of PTCD.After treatment of PTCD,serum bilirubin decreased of17patients.Pruritus, jaundice, general fatigue and abdominal pain improved significantly in100%,66.7%,66.7%,55.6%, of patients, respectively. Improvement of clinical manifestation and decrease of serum bilirubin in patients without liver metastasis is better than that in patients with liver metastasis,the difference was statistically significant (P=0.007).The gender,,peritoneal metastasis,level of obstruction do not have statistical significance.Conclusion:Obstructive jaundice by metastatic gastric cancer is caused by local recurrence。 Percutaneous transhepatic cholangial drainage is one of the palliative methods to treat obstructive jaundice by metastatic gastric cancer.PTCD for patients with liver metastasis is less effective.