An Comparative Study And Prognostic Analysis Of Different Interventional Methods For The Treatment Of Malignant Obstructive Jaundice

Objective:To Compare the different effects of4palliative interventional ways tothe treatment of malignant obstructive jaundice.And to investigate thesurvival and the prongostic factors so as to take correspondingmeasures,appropriate surgical methods and effective postoperativetreatments in advance which will improve the patients’living quality andprolong the survival period.Methods:The clinical data of69patients with malignant obstructive jaundice, werenot the surgery candidates, treated by different palliative interventional waysin department of hepatobiliary surgery of Baoding No2hospital betweenJanuary2008and December2013.The clinical data were retrospectivelyanalyzed.The study parameters which will affect the survival includedgender,age,tumor type,preoperative infection,drainage method,LiverChild-Pugh grade,total bilirubin(TBIL),the postoperative declining degree ofbilirubin and postoperative antineoplastic therapy.We made a single andmultiple factors analysis.Results:The69operations were successful.After different ways of drainage in thetreatment of palliative treatment of malignant obstructive jaundice,the totalbilirubin,direct bilirubin compared with before operation weresignificantly.The yellow extent were no significant difference in palliativeefficacy in one week.But endoscopic metal biliary stent group (EMBS) has abetter palliative efficacy,fewer complications and more expensive than percutaneous transhepatic cholangial drainage (PTCD), percutaneoustranshepatic insertion of biliary stent group (PTBS) and endoscopic retrogradebiliary drainage group (ERBD).PTCD is simple,but has more postoperativecomplications.PTBS has a better effect on high biliary obstruction,and ERBDis suitable for low biliary obstruction.In the9factors affecting survivalprognosis,TBIL,Liver Child-Pugh score, preoperative infection, postoperativeantineoplastic therapy were the related factors.Liver Child-Pugh score≥10points, more pre-existent postoperative infection,no further treatment is theimpact of risk factors for survival outcomes for patients with malignantobstructive jaundice.Conclusion:For not radical surgery patients with malignant obstructivejaundice,choosing the corresponding internal and external bile drainage is asafe and effective measure.4palliative interventional methodsitself is notabsolute.Which method will be chosen is depending on the type of tumor andit’s obstruction of plane.Preoperative improvement of liver function,controlingthe infection and complications,postoperative further for symptomatictreatment of tumor will improve patients’ life quality and prolong survival.