Clinical Analysis Of Obstructive Jaundice Treated By ERCP Of Biliary Tract Dilation Catheter Combined With Endoscopic Biliary Tract Dilation Catheter

Objective:Obstructive jaundice may be caused by a number of reasons.When the majority of malignant obstructive jaundice is found,the patient is not suitable for or can not be eradicated due to a variety of factors to perf orm surgery,thus performing interventional therapy.The purpose of this study was to analyze that the efficacy of ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter in the treatment of obstructive jaundice.Methods:A total of 32 patients treated with ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter due to obstructive jaundice from January 2017 to June 2018 were collected from the first hospital of shanxi medical university.Postoperative body temperature,pulse,blood pressure,abdominal distension and other abdominal signs were monitored in all patients,and hematuria amylase,lipase and liver function were reviewed in the morning of the second day.The liver function was re-examined 1 week after the operation,and the surgical effect was judged according to the preoperative and postoperative clinical manifestations of the patients and the decrease of serum bilirubin.The postoperative adverse reactions and complications of the patients as well as the changes of liver function indexes 1-2 weeks after the operation were observed,and the jaundice regression,recurrence,stent blockage and survival time of the patients were understood through long-term follow-up.Results:1.This group of successful line of ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter treatment of 32 cases of biliary potent 27 cases(84.4%),effective in 2 cases(1 case of pancreatic head carcinoma,1 cases of bile duct cancer)(6.25%),weak effect in 2 cases,bile duct carcinoma(6.25%),1 had no effect(cholangiocarcinoma)(3.1%).The total effective rate of ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter was 90.6%(29/32).Liver function index decreased obviously.2.In this group of patients undergoing ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter the effective rate of the treatment was 100% in patients with benign obstructive jaundice,and the total bilirubin decreased by about 56.2% 1 week after the operation,and no complications of stent blockage,displacement or jaundice recurrence occurred within 3 months after the operation.Compared with malignant obstructive jaundice(jaundice caused by cholangiocarcinoma,pancreatic cancer,ampullary cancer,etc.),the effective rate of treatment was 88.9%,and the total bilirubin decreased by about 52.1% one week after surgery.It was found that in 1 month post operation,3 patients had blockage,that regression of jaundice was unsuccessful,2 patients underwent postoperative 3-month postoperative obstruction reoccurrence and obstructive jaundice.In addition,the postoperative decline of other liver function indexes in patients with benign obstructive jaundice was also higher than that in patients with malignant obstructive jaundice,and the efficacy of ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter in the treatment of benign obstructive jaundice was higher than that of malignant obstructive jaundice.3.In this group of 32 patient with obstru ctive jaundice,most of that biliary ducts present a different degree of secondary biliary expansion in addition to one.Therefore,the higher the degree of bile duct dilation,the higher the TBIL content.Thus only applicable to patients with malignant obs tructive jaundice.Conclusion:The effect of ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter in the treatment of obstructive jaundice was significant.The liver function index of the patients 1 week after t he operation was significantly decreased compared with that before the operation,and the incidence of postoperative complications was low.Although ERCP of biliary tract dilation catheter combined with endoscopic biliary tract dilation catheter requires further improvement in the field of minimally invasive surgery;However,it is undeniable that she has the advantages of safety,effectiveness and none complications in the treatment of obstructive jaundice in clinical practice,and can effectively solve the obstruction and improve the survival time of tumor patients,which is a reliable and recommended method.