Combined biliary drainage for treatment of malignant obstructive jaundice caused by Bismuth Ⅳ Klatskin tumors / 中国介入影像与治疗学

ABSTRACT

Objective To explore the effect of two kinds of combined biliary drainage in the treatment of malignant obstructive jaundice (MOJ) caused by Bismuth Ⅳ Klatskin tumor.Methods Data of 46 MOJ patients caused by Bismuth Ⅳ Klatskin tumor who received combined biliary drainage were retrospectively analyzed.The patients were divided into bilateral percutaneous transhepatic biliary drainage (PTBD) group (n =19) and endoscopic nasobiliary drainage (ENBD) combined with unilateral PTBD group (n=27).Internal and external drainage of the biliary tract were performed.The clinical effect of drainage,survival time and complication rate after drainage were compared between the two groups.Results The technical success rates of drainage in both groups were 100％.There was no statistically significant difference in the effective rate of drainage between the two groups (89.47％ [17/19] vs 92.59％ [25/27];x2=0.02,P=0.831).Compared with ENBD combined with unilateral PTBD group,patients in bilateral PTBD group showed longer survival time ([318.37±167.39] days vs [267.57±145.21] days;t=7.31,P=0.007) and lower complication rate (10.52 ％[2/19] vs 14.81％ [4/27];x2 =1.92,P=0.028) after drainage.Conclusion Combined biliary drainage techniques can effectively alleviate MOJ caused by Bismuth 1Ⅳ Klatskin tumors and improve liver function.Bilateral PTBD is more beneficial to prolong patients;survival time than ENBD combined PTBD.