The Clinic Study Of Endoscopic Diagnosis And Treatment In Patients With Benign And Malignant Biliary Stricture

Objective: To explore the measures and clinical value of endoscopic diagnosisand treatment in patients with benign and malignant biliary stricture.Methods: The clinical records of 223 patients with biliary stricture fromOctober 2004 to March 2007 was reviewed retrospectively.with the examination ofBus,CT,ERCP,MRCP,We evaluated the advantage and disadvantage of eachexamination, and decided which was the best method in diagnosis benign andmalignant biliary stricture. A total of 117 patients (mean age 44.2+/-12.9 years) withbenign biliary strictures were included in this study. Among the patients, 102 pationswere selected to treatment group with successful endoscopy, while another 15 patientsas control group were received surgery treatment. The change of hepatic-function,thetime of in-hospital and the early complications were observed. There were 106patients (mean age 44.2+/-12.9 years) with malignant biliary strictures receivedendoscopic treatment. We observed the change of hepatic-function, evaluated theclinical effection of ENBD,ERBD,EMBE, and analysed the survival time of thepatients.Results: Duodenoscopy was successfully completed in 199 patients, with asuccess rate of 91.7%.The specality of Bus,CT,MRCP,ERCP were 78.4%,86.1%,91.8%,95.5%.Bus+CT, Bus+CT+ERCP, Bus+CT+MRCP can improve thespecality.Endoscopic drainage success rate was 90.3% in patients with benign biliarystrictures, The level ofTBIL,ALT,ALP was significant different on 7,14th dayafter treatment between the two groups. The patients were pain less and recoveryfaster. So, the postoperative hospitalization period was much shorter than Surgerygroup. The success rate of Endoscopic drainage in patients with malignant was 91.5% (97/106), ENBD,ERBD and EMBE can relieved their symptoms of biliaryobstruction effectively. Each of them was significant different. The average survivaltime of 97 patients were 13.84 M, While ENBD 3.3M,ERBD 5.43M,EMBE15.82M, each of the survival time was significant different (p＜0.01)。Conclusion: ERCP was the best method in diagnosis of biliary stricture of thestudy, while Bus and CT could be regard as useful examination. Because ofun-invasive, MRCP was regard as the first examination in biliary stricture. Bus+CT+ERCP were the best examination. Endoscopy drainage in patients with benign andmalignant biliary stricture was less invasive,safe,effective. However biliary stentcould not instead of surgery in benign biliary stricture now. The average survival timeof EMBE in malignant biliary stricture much better than ERBD,ENBD.