The Clinical Curtive Effect Analysis Of ERCP Solve Malignant Extrahepatic Biliary Obstruction By Biliary Drainage

Objective:To explore the endoscopic retrograde biliary imaging (ERCP) in biliarydrainage of the pancreatic duct the curative effect of clinical application in malignantbiliary obstruction.Methods:Analysis various clinical data of86patients with malignant biliary obstruction,such as: pathologic results (microscopically small specimens, cytologicalexamination, surgical postoperative general pathology),clinic significance ofpositive signs and clinical manifestation, laboratory test resultsafter admissionserum enzymology,image diagnosis(MRI, MRCP and CT, abdomen colour toexceed), the results of diagnosis and treatment of ERCP and other clinical data. Inendoscopic biliary drainage way into nasal biliary drainage (ENBD) group of46cases; Plastic biliary stent (ERBD) of36cases, metal biliary stent (EMBE) group of25cases, statistical analysis changes before and after each other satisfaction drainage,drainage of liver result, two types of long-term drainage (ERBD and EMBE) stentpatency and the survival of patients with time.Results: In86patients with malignant biliary obstruction,13cases of hepaticbile duct carcinoma of the portal vein,Bile duct36cases of middle period ofcancer,19cases of duodenal papilla and pot of abdominal malignant placeholder,12cases of pancreatic cancer,The other6cases of metastatic carcinoma.ERCPtreatment of86patients112times in total, the success of duodenal papilla retrogradeintubation107times, ERCP intubation success rate of95.5%.Afrter treatment thepatients’ clinical symptoms within a week the drainage improved markedly, theoverall effective rate was92.5%.Most laboratory examination indexes such as liverresult is almost normal, before and after endoscopic biliary drainage five indicatorsof liver function enzymology numerical changes,The paired t test, it is concludedthat the five indicators of P value is less than0.05(P <0.05), statistically difference.Incidence of complications of endoscopic biliary drainage was4.7%.ENBD group average survival time for patients with d (208.1+96.8), theaverage flow time was (83.9±36.4) d (25~201)d; EMBE group average survivaltime (274.1±98.5) d；EMBE group average survival time (274.1±98.5) d, EMBEgroup average flow time was (262.7±98.7) d (75~460)d.ERBD and EMBEsurvival time after the Log-rank test, the two groups P=8.167(P>0.05), nostatistical significance;With two kinds of stent patency time after the paired t test, P<0.001, namely ENBD and EMBE compared two groups of stent patency timedifference statistically.Conclusion:1. The biliary drainage (ERBD, ENBD, EMBE) small trauma, low cost,safety.Can quickly relieve jaundice symptoms of patients with malignant biliaryobstruction, promote liver functional recovery in the short term, reduce liver enzymelevels, improve survival quality and prolong survival time.Palliative treatment effectis satisfactory. Therefore, endoscopic biliary drainage is worth popularization andapplication in clinic.2. Metal biliary stent drainage and plastic biliary stent drainageon the impact on the survival time of patients with no statistical difference,But underthe same time surial in patients with biliary metallic stents than plastic stent inpatients with biliary tract.Plastic biliary stent patency time mostly for three months,biliary metallic stent patency time more than6months.As a long-term biliarydrainage way, flow time of biliary metallic stent group was obviously better than inplastic biliary stent group4. Although biliary stents are more expensive, but canquickly relieve biliary stents malignant biliary obstruction, helps the liver enzymelevels, recovery and long-term drainage is obviously better than the flow time andflow rate of biliary plastic bracket, therefore in the treatment of malignant biliaryobstructive jaundice is recommended to use in palliative care.