两种不同途径胆道支架置入术治疗恶性梗阻性黄疸的临床疗效评价

目的对比经内镜逆行性胰胆管造影术(ERCP)与经皮肝穿刺胆道引流术(PTCD)治疗恶性梗阻性黄疸(MOJ)病人的临床疗效。方法回顾性分析MOJ病人113例临床资料，按照支架置入途径分为ERCP组48例和PTCD组65例。比较2组手术成功率、临床疗效、术后并发症、住院时间及住院费用。结果ERCP组与PTCD组总体手术成功率、高位及低位梗阻的手术成功率、黄疸总体缓解率、并发症发生率、住院费用差异均无统计学意义(P>0.05)。ERCP组高位梗阻黄疸缓解率、病人住院时间均低于PTCD组(P < 0.05)。ERCP组低位梗阻黄疸缓解率高于PTCD组(P < 0.05)。结论ERCP与PTCD治疗MOJ病人具有显著临床疗效，ERCP对于低位梗阻更有优势，PTCD对于高位梗阻更具优势。临床医师需结合病人具体情况选择ERCP或PTCD。

Evaluation of clinical efficacy of two different approaches with biliary stent implantation in the treatment of malignant obstructive jaundice

ObjectiveTo compare the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangial drainage (PTCD) in the treatment of malignant obstructive jaundice (MOJ).MethodsA total of 113 patients with MOJ were retrospectively analyzed.They were divided into ERCP group (n=48) and PTCD group(n=65) according to stent placement route.The success rate of operation, clinical efficacy, postoperative complications, hospitalization days and hospitalization expenses were compared between the two groups.ResultsThere were no significant differences in the overall success rate of surgery, the success rate of high obstruction surgery, the success rate of low obstruction surgery, the overall remission rate of jaundice, the incidence of complications and hospitalization expenses between the ERCP group and PTCD group(P>0.05).The remission rate of high obstruction jaundice and hospitalization days in ERCP group were lower than those in PTCD group(P < 0.05).The remission rate of low obstructive jaundice in ERCP group was higher than PTCD group(P < 0.05).ConclusionsERCP and PTCD have significant clinical efficacy in the treatment of MOJ patients.For the patients with low obstruction, the use of ERCP can provide more advantages, while for the patient with high obstruction, the use of PTCD has more advantages.The appropriate treatment method(ERCP or PTCD) should be chosen by clinicians according to the specific situation of the patient.