Observation of the clinical effect of ERCP biliary metal stent implantation and PTCD in the treatment of malignant obstructive jaundice / 中国综合临床

ABSTRACT

Objective To observe the clinical effect of endoscopic retrograde cholangiopancreatography (ERCP)biliary stent implantation and percutaneous transhepatic cholangiography(PTCD)in the treatment of malignant obstructive jaundice(MOJ).Methods Eighty-eight patients with MOJ treated in the Second Affiliated Hospital of Hainan Medical University from January 2013 to March 2016 were selected and then randomly divided into ERCP group and PTCD group,44 cases in each group.ERCP group received biliary tract stent implantation via ERCP pathway, and PTCD group underwent percutaneous transhepatic biliary puncture.The success rate,clinical efficacy,liver function and complication rate of the two groups were compared.Results The success rate of ERCP group was 93.18%(41/44),and the success rate of PTCD group was 90.91%(40/44).There was no significant difference between the two groups(P>0.05).In terms of the clinical curative effect,the total effective rate of ERCP group was 92.68%(38/41),the total effective rate of PTCD group was 90.00%(36/40),there was no significant difference between the two groups(P>0.05);the low obstruction efficiency in ERCP group was significantly higher than that of PTCD group(100.00%vs.75%),the high obstruction efficiency in ERCP group was significantly higher than that of PTCD group (96.43% vs.83.33%),the differences between the groups were statistically significant(χ2=3.503,2.771,P<0.05);in terms of the liver function recovery after treatment,the liver function index of patients with low obstruction in ERCP group were better than that in patients with high obstruction,while in PTCD group,patients with high obstructive had better liver function,compared to the low obstruction patients,the differences were statistically significant(P<0.05); the complication rate in ERCP group and PTCD group were11.36% and 15.91%,the difference was not statistically significant(P>0.05).Conclusion The ERCP pathway and PTCD pathway implantation of biliary metal stent have great clinical efficacy,while in comparison,ERCP pathway performs better in low obstruction and PTCD pathway was more suitable in high obstruction.In the course of clinical treatment,the selection of surgical approach should be based on the different obstruction sites of the patients,so as to obtain the best therapeutic effect.