| Objective:To evaluate the effect and clinical value of endoscopic retrograde biliary drainage in malignant biliary obstructiction.Methods:The clinical data of 27 cases of malignant biliary obstructiction patients treated with endoscopic retrograde biliary drainage (endoscopic group) and 25 cases of patients treated with nickel-titanium memory allory stent by surgery (surgery group) were collected and the clinical effect and hospital stay and patient survival between the groups were compared. The prognosis factors of malignant biliary obstruction were analyzed by Cox's regression model.Results:The effective rates of reducing the level of serum bilirubin and drainage between the endoscopic group and surgical group were 92.6% and 76.0% (P=0.092) respectively, which indicated that there were no statistically difference between the groups. The endoscopic group had a lower rates for early complications (36.0% vs 76.0%; P=0.004), and a shorter hospital stay (median, 7 vs 22 days; P=0.000) than that of surgery group. Despite the early benefits of endoscope, no significant difference in the median patient survival time between the two groups was found (endoscopic group, 202 days; surgical group, 191 days; P=0.986). The Cox's regression model analysis showed that whether the patients received continue treatment of endoscopic drainage when recurrent obstruction occurred affected postoperative survival significantly. The patients who received continue endoscopic drainage have a long survival(P=0.005).Conclusion:1. Endoscopic retrograde biliary drainage and Nickel-titanium memory allory stent drainage by surgery are effective palliation treatment,The former is associated with fewer early complications and shorter hospital stay,but no significantly difference in the mean patient survival.2. When recurrent obstruction occurred after biliary drainage,receiving continue endoscopic drainage had a long survival.
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