| PrefacePatient with malignant obstructive jaundice is caused by various malignant tumor or carcinogenic lymph nodes which invade and press bile duct and lead to jaundice. The traditional treatment for malignant obstructive jaundice is surgical method which has firm effect. Recent method for the patient who lost operative chance is PTCD and stent deployed - usually metallic and plastic stent - within bile duct. This method is reported by many document and has firm effect. But now the research of therapeutic effect comparison between both method is insufficient.ObjectiveOur research aim at the difference between the time at which patient of malignant obstructive jaundice with the two method appear secondary jaundice, therefore we can judge the clinical therapeutic effect between both methods.Methods/materialsObject of study: collection of 24 patient with malignant obstructive jaundice include 18 males and 6 females whose age range from 39 to 83 and is about 61. 4 in average. There are 16 patients with carcinoma of bile duct, 3 patients with lymph nodes metastasis invading bile duct after operation of gastric carcinoma, 2patients with carcinoma of pancreatic head, 3 patients with hepatic carcinoma. We divide the 26 patients into two groups. One group with 17 patients included has the treatment of metallic stent deployed, and the other group with 7 patients included has plastic stent deployed.Experimental method;Experimental devices:Operative instrument:Experimental method: PTCD was performed firstly. Puncture left or right intrahepatic bile duct using needle (COOK, 5F, for bileduct) , then followed cholangiography which was to define the site and extent of bile stenosis. Guide-wires were put through the stenostic parts, and take out the drivepipe of needles, and then various drainage catheters with multipore were put into the bile duct through guidewires. Thus the inner drainage had been completed so far. Sometimes inner drainage was not performed easily, a drainage catheter should be inserted to the bile ducts firstly for 3 -7days, and after drainage the guide-wires should be easier in putting in to duodenum. Cholangiography was performed at 7 - 10 days after inner drainage. If the dilating bile duct contract back to normal size and the picture of stenotic part was detected clearly, then metallic or plastic stent should be deployed in bile ducts under the guidance of fluorosco-py. For the cases who were deployed metallic stent, the drainage catheters should be closed and retained in the bile ducts for 3 - 5 days, and then cholangiography was perfored again to make sure whether the stent expand well or not. If the stents had got good position and well expanded, the drainage catheters should be removed after cholangiography. For the cases who were deployed plastic stent, the drainage catheters should be removed instantly after stent deployed and while it was proved that stent had got well position by cholangiography. TAE or TAI procedures were performed regularly for 1 - 3 times in all patients after the bile duct stenting.Observeing Index: In the 24 patients, 26 self - expanding metallic stents were deployed in 17 patients, and 10 plastic stents were deployed hi 7 patients. The decreasing value of bilirubin of patient before stent deployed and the time at which they appear secondary jaundice were chosen as observative index.Statistical management: because the number of two group was not equal, log test and t test were 4used, and = 0.05 was taken as test standard.ResultPTCD and bile duct stenting were performed successfully in all of 24 patients without any severe complications.There was no significant statistical difference of bilirubin decreasing value between before and after treatment ( P > 0.2 ).There was statistic difference in the time of secondary jaundice appearing of both group ( P < 0. 05 ). The duration of secondary jaundice in metallic stent goup was longer than the plastic stent group.The plastic stents was pushed to the duodenum successfully in 2 case...
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