Comparison Between Interventional Treatment and Operation Drainage for Malignant Obstructive Jaundice_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIN Bo , ZHANG Linbo , JIANG Xiyuan , CAO Shu.

Department of General Surgery of 208 Hospital of PLA, Changchun 130062, China;

Corresponding author：

Keywords：

Malignant obstructive jaundice; Interventional therapy; Operation drainage; Complication; Therapeutic effect

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the therapeutic effect of percutaneous transhepatic cholangial drainage (PTCD) and operation drainage for the patients with inoperable malignant obstructive jaundice.
Methods A total of 131 patients with inoperable malignant obstructive jaundice were treated in this hospital, in which 102 patients had PTCD by placement of metallic stent and (or) plastic tubes to remove obstruction of bile duct (interventional treatment group). Simultaneously 29 patients were selected for operation by intraexternal drainage (operation drainage group). The patients were followed up for comparison of the serum level of total bilirubin, postoperative complications, average length of hospitalization and average cost between the two groups.
Results PTCD was successfully performed in all the patients of the interventional treatment group. There were no significant differences of 50% decrease period of average total bilirubin level or postoperative complications between the two groups (P gt;0.05). The average length of hospitalization and average cost of interventional treatment group were less than those of operation drainage group (P lt;0.05).
Conclusions Compare with operation drainage, interventional treatment can reduce average length of hospitalization and average cost, without increase of postoperative complications, which is a main chance of treatment for malignant obstructive jaundice.

Citation： XIN Bo,ZHANG Linbo,JIANG Xiyuan,CAO Shu.. Comparison Between Interventional Treatment and Operation Drainage for Malignant Obstructive Jaundice. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(3): 233-236. doi: Copy

1.	Qian XJ, Zhai RY, Dai DK, et al. Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment [J]. World J Gastroenterol, 2006; 12(2): 331335.
2.	陈颐, 王小林, 王建华, 等. 胆道支架置放结合动脉化疗栓塞治疗恶性梗阻性黄疸 [J]. 复旦学报(医学科学版), 2001; 28(6): 516518.
3.	Schoder M, Rossi P, Uflacker R, et al. Malignant biliary obstruction: treatment with ePTFEFEPcovered endoprostheses initial technical and clinical experiences in a multicenter trial [J]. Radiology, 2002; 225(1): 3542.
4.	Arguedas MR, Heudebert GH, Stinnett AA, et al. Biliary stents in malignant obstructive jaundice due to pancreatic carcinoma: a costeffectiveness analysis [J]. Am J Gastroenterol, 2002; 97(4): 898904.
5.	Boguth L, Tatalovic S, Antonucci F, et al. Malignant biliary obstruction: clinical and histopathologic correlation after treatment with selfexpanding metal prostheses [J]. Radiology, 1994; 192(3): 669674.
6.	Eickhoff A, Schilling D, Jakobs R, et al. Longterm outcome of percutaneous transhepatic drainage for benign bile duct stenoses [J]. Rocz Akad Med Bialymst, 2005; 50: 155160.
7.	杨林，谢晓东，王朝华，等. 经皮肝穿胆道引流术治疗恶性梗阻性黄疸 [J]. 中国普外基础与临床杂志, 2004; 11(4): 299.
8.	李海洋, 孙诚谊, 潘耀振, 等. 不同途径胆道支架置入治疗恶性梗阻性黄疸42例回顾分析 [J]. 中国普外基础与临床杂志, 2009; 16(4): 300303.
9.	吴言涛. 梗阻性黄疸的围手术期处理 [J]. 中国普外基础与临床杂志, 2003; 10(3): 183185.
10.	郑兴学, 陈治, 王鹏, 等. PTCD治疗梗阻性黄疸137例分析 [J]. 中华普外科手术学杂志(电子版), 2009; 3(1): 5153.
11.	钱晓军，戴定可，翟仁友．恶性梗阻性黄疸介入治疗的疗效分析 [J]．中华肝胆外科杂志, 2004; 10(11): 752755．.
12.	夏永辉, 徐克, 苏洪英, 等. 晚期恶性梗阻性黄疸经皮介入治疗近期并发症的临床观察及处理 [J]. 中国介入放射学, 2009; 3(1): 8890.
13.	Hartmann D, Jakobs R, Schilling D, et al. Endoscopic and radiological interventional therapy of benign and malignant bile duct stenoses [J]. Zentralbl Chir, 2003; 128(11): 936943.
14.	van Delden OM, Laméris JS. Percutaneous drainage and stenting for palliation of malignant bile duct obstruction [J]. Eur Radiol, 2008; 18(3): 448456.
15.	Indar AA, Lobo DN, Gilliam AD, et al. Percutaneous biliary metal wall stenting in malignant obstructive jaundice [J]. Eur J Gastroenterol Hepatol, 2003; 15(8): 915919.
16.	施海彬, 李麟荪, 徐泽宽, 等. 经皮肝穿刺胆道内支架置入术治疗恶性梗阻性黄疸 [J]. 南京医科大学学报(自然科学版), 2002; 22(2): 138140.
17.	李海民, 窦科峰, 周景师, 等. 恶性梗阻性黄疸影像学诊断的比较分析 [J]. 中国普外基础与临床杂志, 2004; 9(5): 342344.
18.	秦孝军, 贾广志, 尹华. PTC与MRCP对恶性梗阻性黄疸的诊断及指导治疗价值的对比研究 [J]. 内蒙古医学院学报, 2009; 31(3): 214217.
19.	杨树林, 姜喜远, 王凯民，等. 肝总管十二指肠架桥内引流治疗梗阻性黄疸 [J]. 中华肝胆外科杂志, 2003; 9(2): 94．.
20.	曹广, 杨仁杰. 金属支架姑息治疗恶性梗阻性黄疸的术后随访及生存分析 [J]. 北京大学学报(医学版), 2008; 40(2): 121124.
21.	Dinkel HP, Triller J. Primary and longterm success of percutaneous biliary metallic endoprotheses (Wallstents) in malignant obstructive jaundice [J]. Rofo, 2001; 173(12): 10721078.
22.	Yoshida H, Mamada Y, Taniai N, et al. Onestep palliative treatment method for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of an expandable metallic stent [J]. World J Gastroenterol, 2006; 12(15): 24232426.
23.	高健, 杜湘珂, 金龙, 等. 自膨胀式支架在梗阻性黄疸治疗中的应用 [J]. 中国医学影像技术, 2002; 18(5): 419421.
24.	Bruha R, Petrtyl J, Kubecova M, et al. Intraluminal brachytherapy and selfexpandable stents in nonresectable biliary malignancies－the question of longterm palliation [J]. Hepatogastroenterology, 2001; 48(39): 631637.
25.	游洋, 常钢, 孟凡喆. 胆道支架置入联合碘125 粒子腔内照射治疗恶性梗阻性黄疸的临床应用 [J]. 西安交通大学学报(医学版), 2007; 28(2): F0003F0004.
26.	刘岩, 杨光, 于友涛，等. 经皮肝穿刺胆道支架置放结合动脉化疗栓塞治疗恶性梗阻性黄疽 [J]. 世界华人消化杂志, 2004; 12(6): 14951497.

1. Qian XJ, Zhai RY, Dai DK, et al. Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment [J]. World J Gastroenterol, 2006; 12(2): 331335.
2. 陈颐, 王小林, 王建华, 等. 胆道支架置放结合动脉化疗栓塞治疗恶性梗阻性黄疸 [J]. 复旦学报(医学科学版), 2001; 28(6): 516518.
3. Schoder M, Rossi P, Uflacker R, et al. Malignant biliary obstruction: treatment with ePTFEFEPcovered endoprostheses initial technical and clinical experiences in a multicenter trial [J]. Radiology, 2002; 225(1): 3542.
4. Arguedas MR, Heudebert GH, Stinnett AA, et al. Biliary stents in malignant obstructive jaundice due to pancreatic carcinoma: a costeffectiveness analysis [J]. Am J Gastroenterol, 2002; 97(4): 898904.
5. Boguth L, Tatalovic S, Antonucci F, et al. Malignant biliary obstruction: clinical and histopathologic correlation after treatment with selfexpanding metal prostheses [J]. Radiology, 1994; 192(3): 669674.
6. Eickhoff A, Schilling D, Jakobs R, et al. Longterm outcome of percutaneous transhepatic drainage for benign bile duct stenoses [J]. Rocz Akad Med Bialymst, 2005; 50: 155160.
7. 杨林，谢晓东，王朝华，等. 经皮肝穿胆道引流术治疗恶性梗阻性黄疸 [J]. 中国普外基础与临床杂志, 2004; 11(4): 299.
8. 李海洋, 孙诚谊, 潘耀振, 等. 不同途径胆道支架置入治疗恶性梗阻性黄疸42例回顾分析 [J]. 中国普外基础与临床杂志, 2009; 16(4): 300303.
9. 吴言涛. 梗阻性黄疸的围手术期处理 [J]. 中国普外基础与临床杂志, 2003; 10(3): 183185.
10. 郑兴学, 陈治, 王鹏, 等. PTCD治疗梗阻性黄疸137例分析 [J]. 中华普外科手术学杂志(电子版), 2009; 3(1): 5153.
11. 钱晓军，戴定可，翟仁友．恶性梗阻性黄疸介入治疗的疗效分析 [J]．中华肝胆外科杂志, 2004; 10(11): 752755．.
12. 夏永辉, 徐克, 苏洪英, 等. 晚期恶性梗阻性黄疸经皮介入治疗近期并发症的临床观察及处理 [J]. 中国介入放射学, 2009; 3(1): 8890.
13. Hartmann D, Jakobs R, Schilling D, et al. Endoscopic and radiological interventional therapy of benign and malignant bile duct stenoses [J]. Zentralbl Chir, 2003; 128(11): 936943.
14. van Delden OM, Laméris JS. Percutaneous drainage and stenting for palliation of malignant bile duct obstruction [J]. Eur Radiol, 2008; 18(3): 448456.
15. Indar AA, Lobo DN, Gilliam AD, et al. Percutaneous biliary metal wall stenting in malignant obstructive jaundice [J]. Eur J Gastroenterol Hepatol, 2003; 15(8): 915919.
16. 施海彬, 李麟荪, 徐泽宽, 等. 经皮肝穿刺胆道内支架置入术治疗恶性梗阻性黄疸 [J]. 南京医科大学学报(自然科学版), 2002; 22(2): 138140.
17. 李海民, 窦科峰, 周景师, 等. 恶性梗阻性黄疸影像学诊断的比较分析 [J]. 中国普外基础与临床杂志, 2004; 9(5): 342344.
18. 秦孝军, 贾广志, 尹华. PTC与MRCP对恶性梗阻性黄疸的诊断及指导治疗价值的对比研究 [J]. 内蒙古医学院学报, 2009; 31(3): 214217.
19. 杨树林, 姜喜远, 王凯民，等. 肝总管十二指肠架桥内引流治疗梗阻性黄疸 [J]. 中华肝胆外科杂志, 2003; 9(2): 94．.
20. 曹广, 杨仁杰. 金属支架姑息治疗恶性梗阻性黄疸的术后随访及生存分析 [J]. 北京大学学报(医学版), 2008; 40(2): 121124.
21. Dinkel HP, Triller J. Primary and longterm success of percutaneous biliary metallic endoprotheses (Wallstents) in malignant obstructive jaundice [J]. Rofo, 2001; 173(12): 10721078.
22. Yoshida H, Mamada Y, Taniai N, et al. Onestep palliative treatment method for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of an expandable metallic stent [J]. World J Gastroenterol, 2006; 12(15): 24232426.
23. 高健, 杜湘珂, 金龙, 等. 自膨胀式支架在梗阻性黄疸治疗中的应用 [J]. 中国医学影像技术, 2002; 18(5): 419421.
24. Bruha R, Petrtyl J, Kubecova M, et al. Intraluminal brachytherapy and selfexpandable stents in nonresectable biliary malignancies－the question of longterm palliation [J]. Hepatogastroenterology, 2001; 48(39): 631637.
25. 游洋, 常钢, 孟凡喆. 胆道支架置入联合碘125 粒子腔内照射治疗恶性梗阻性黄疸的临床应用 [J]. 西安交通大学学报(医学版), 2007; 28(2): F0003F0004.
26. 刘岩, 杨光, 于友涛，等. 经皮肝穿刺胆道支架置放结合动脉化疗栓塞治疗恶性梗阻性黄疽 [J]. 世界华人消化杂志, 2004; 12(6): 14951497.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison Between Interventional Treatment and Operation Drainage for Malignant Obstructive Jaundice

Abstract Full text Figures/Tables Video References Cited by

Format

Content