对比观察超声引导下经皮经肝胆管穿刺引流术与经皮经肝胆囊穿刺引流术姑息治疗晚期恶性梗阻性黄疸

目的比较超声引导下经皮经肝胆管穿刺置管引流术(PTBD)及经皮经肝胆囊穿刺置管引流术(PTGD)姑息治疗晚期恶性梗阻性黄疸的价值。方法纳入79例晚期恶性梗阻性黄疸患者,其中47例共接受120次超声引导下PTBD(PTBD组),32例共接受39次PTGD(PTGD组)。比较PTBD组和PTGD组手术操作时间、黄疸减退情况、胆道出血和胆汁外漏发生率及引流管有效带管时间。结果两组黄疸减退情况、胆道出血和胆汁外漏发生率差异均无统计学意义(P均0.05);PTBD组手术操作时间为(7.07±2.24)min,PTGD组操作时间为(5.94±2.03)min,差异有统计学意义(P=0.02)。PTBD组有效带管时间为(100.56±11.31)天,PTGB组为(63.58±6.23)天,差异有统计学意义(P0.001)。结论对晚期恶性梗阻性黄疸患者,超声引导下PTBD带管时间长,相对PTGD更为适用。

Comparison between ultrasound-guided percutaneous transhepatic bile-duct drainage and percutaneous transhepatic gallbladder drainage in treatment of late-stage malignant obstructive jaundice

Objective To compare the value of ultrasound-guided percutaneous transhepatic bile-duct drainage (PTBD) with percutaneous transhepatic gallbladder drainage (PTGD) in treatment of late-stage malignant obstructive jaundice. Methods Totally 79 patients with late-stage malignant obstructive jaundice underwent 120 times of PTBD (PTBD group, 47 cases) and 39 times of PTGD (PTGD group, 32 cases). The operation time, decreasing of bilirubin in blood, the incidence of bleeding in bile duct and biliary leakage, and the effective drainage time for one catheter were respectively compared between PTBD group and PTGD group. Results There was no significant difference between PTBD and PTGD group in bilirubin decreasing in blood, nor the incidence of bleeding in bile duct and biliary leakage (all P>0.05) . The mean operation time of PTBD was (7.07±2.24)min, while of PTGD was (5.94±2.03)min (P=0.02). The mean effective drainage time per catheter in PTBD group was (100.56±11.31) days, longer than that in PTGD group ([63.58±6.23] days, P<0.001). Conclusion Ultrasound-guided PTBD is more appropriate than PTGD for prolonging effective drainage time in treatment of late-stage malignant obstructive jaundice.