| Malignant obstructive jaundice was caused by some malignant tumours which involved the bile duct, and thus biliary obstruction was exist. It was believed that Interventional therapy was one of the best methods in treatment of malignant obstructive jaundice in the past ten years. Unfortunately, we had done little studies hi this field of China, especially in the study about survival time, survival rate after interventional treatment.PURPOSETo analyze the value of percutaneous interventional therapy in malignant biliary obstruction; to compare the efficiency of percutaneous transhepatic cholangical drainage ( PTCD) and biliary stent deployment after catheter drainage; to compare the efficiency of interventional therapy with and without transcatheter infusion chemotherapy (TAIC).MATERIALS/METHODNinety - seven patients ( male 71, female 26, 22 ~ 83 yeas old age , average age 59 ) , with malignant obstructive jaundice ( whichwere diagnosed by clinical radiology and laboratory test, and proved by follow - up) , were treated percutaneously with 123 bile duct drainage catheters ( single catheter used in 72 cases, double catheters used in 24 cases, and three catheters in 1 case). 43 metallic self- expanding stents (including 1 covered stent) and 7 plastic stents were deployed subsequently. In all the patients, drainage catheters were implanted under the guidance of ultrasound and fluoroscopy firstly, then 35. 1 % ( 34/97) cases were deployed bile duct stent. 46.4 % ( 457 97) cases underwent TAIC once a month after percutaneous bile duct drainage or after deployment of stent.SHIMADZU 2400a digital subtraction system, 19 -21G PTCD needles, drainage catheters of 6 - 12 French, biliary metallic stents (10mm in diameter,3 - 8mm in length) , plastic stents of 10 - 12 French.To observe the change of total and direct serum birubicin after treatment. To compare the average survival time ( AST) of PTCD group and biliary stent deployment group in statistical methods, and to compare the AST of another 2 groups, one is the cases of intervention-al therapy with TAIC, the other group is the rest cases without TAIC.RESULTSAll the patients were underwent PTCD successfully without any serious complication. The survival time was from 3 to 30 months. The AST was 11. 08 months. The AST of PTCD group was 8. 75 months and the AST of biliary stent deployment group was 15.41 months. The AST of biliary stent deployment group was longer than that of PTCD group ( P <0.05). The AST of TAIC group (15.18 months) was Ion-ger than that of non - TAIC group (7.54 months) (P <0. 01) .DISCUSSIONPTCD is an important step in the interventional treatment of malignant obstructive jaundice, after which the biliary stents could be deployed accurately. There were no more severe complications after PTCD in this group, probably because percutaneous puncture was guided by ultrasound and fluroscopy.Many doctors preferd interventional methods to surgery in the treatment of malignant obstructive jaundice because of less invasion, but there were still argument between interventional radiologists and surgeons in this field. We were satisfied with the results in this study, the AST of all patients was 11. 08 months. But if we compared the AST between PTCD group and biliary stent deployment group, we found that the AST of biliary stent deployment group was 6. 66 months longer than that of PTCD group ( P < 0. 05 ) . It was proved that biliary stents shoud be widen used in the treatment of malignant obstructive jaundice if possible. When the biliary stents were deployed, the drainage catheters would be removed, and the possibility of infection of bile duct would be reduced. That was another probable reason why the AST of biliary stent deployment group was longer. Furthermore, the patient felt better when the catheters were removed.We also compared the AST between TAIC group and non - TAIC group. The AST of TAIC group was 7. 64 months longer than that of non - TAIC group (P<0.01). It was proved that TAIC was helpful in treatment of...
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