Effect And Prognostic Analysis Of Different Drainage Methods In Treatment Of Malignant Obstructive Jaundice

Research purposes:Discuss the effect,complications,smooth drainage,and survival prognosis of different biliary drainage methods in the treatment of malignant obstructive jaundice;make an objective evaluation of the two drainage methods,provide an objective reference for clinical decision-making,and discuss some patients with malignant obstructive jaundice.The prognosis is analyzed and evaluated.research method:A retrospective analysis of 80 patients with malignant obstructive jaundice who underwent percutaneous transhepatic biliary drainage(PTCD)in the Interventional Department of Anhui Provincial Hospital from January 2019 to December 2019(All patients received were evaluated before drainage to confirm that there was no radical cure Patients who have opportunities for sexual surgery,or whose physical condition cannot tolerate radical surgery,and who refuse to undergo radical surgery),are divided into two groups according to the drainage method used during the operation: 55 people with indwelling internal and external drainage tubes,and indwelling external drainage tubes Jointly placed a biliary stent to drain 25 people.Retrospective analysis was conducted by collecting and comparing the clinical data and liver function indicators,complication rate,length of stay,cost,and survival time of patients before and after surgery.result:The ALT,GGT,TBIL,and ALP indexes of the two groups of patients with internal and external drainage tube drainage and stent combined with external drainage tube decreased significantly after surgery.The clinical symptoms of jaundice in the patients were significantly improved compared with that before operation.There was a statistically significant difference between the indexes and the preoperative comparison.(P<0.05),there was no significant difference in the postoperative decline between the two groups(P>0.05).There was no significant difference between the ERCP group and the PTCD group in the short-term postoperative complications(P>0.05).The postoperative complication rate of the internal and external drainage tube group was higher than that of the stent combined external drainage tube group,and the difference was statistically significant(P <0.05).The average patency time of biliary drainage in the two groups was(9.01 ± 4.38)and(6.79 ± 3.13)months,respectively,and the difference was statistically significant(P <0.05).The average postoperative survival time was(12.08 ± 5.38 and(9.10 ± 4.16)months,respectively,and the difference in survival time was statistically significant(P <0.05).Univariate and multivariate analysis showed that the type of biliary stent and liver metastases It is an independent factor that affects the patient’s generation time.conclusion:For patients with malignant obstructive jaundice,internal and external drainage tube drainage and single stent combined with external drainage tube drainage for PTCD surgery can relieve biliary obstruction and alleviate the curative effect of abnormal liver function caused by obstructive jaundice.Drainage tube drainage has a slightly higher complication rate than biliary stent combined with external drainage tube drainage,and patients do not need to wear the tube for a long time after the external drainage tube is pulled out.The internal and external drainage tube drainage can be used as an important supplement to the biliary stent drainage.Patients who have failed access,have related surgical contraindications,and cannot afford the cost of stents,may consider combined internal and external drainage catheters.At the same time,the use of radioactive 125 I particle stents can help improve the survival of patients,and for patients with multiple liver metastases,targeted adjuvant treatment should be given to improve the prognosis of patients.