The Clinical Observation Of Interventional Therapy For Malignant Obstructive Jaundice

Objecfive:Malignant obstructive jaundice is a common disease clinically, and when diagnose, most of the patients have lost the opportunity of operative eradication, operation. PTBD/PTBS have become one of the main therapeutic method of malignant obstructive jaundice which has lost operative opportunity. They have certain curative effect, small trauma and liess complication. This study aim at the clinical outcome and its relative influencing factors of interventional therapy in dealing malignant obstructive jaundice(MOJ). Methods:Between October 2006 and February 2010, one hundred and forty six MOJ patients,84 males and 62 females, aged(63±13), underwent interventional therapy:105 patients received percutaneous transhepatic biliary drainage(PTBD) including external drainage or external-internal drainage, and 41 underwent percutaneous transhepatic biliary stent(PTBS) implantation. No major complications associated with the execution of PTBD occurred. The various symptoms caused by jaundice, such as anorexia, itching, nausea, abdominal pain and fever, were relieved in one hundred and twenty nine patients within one week after PTBD.3-7days after the procedure, total bilirubin(TB), direct bilirubin(DB), alanine transaminase(ALT), alkaline phosphatase(ALP), y-glutamyl transpeptidase(y-GT) and albumin were examined. One week after,37 of the patients underwent transcatheter arterial chemoembolization(TACE). Results:One week after drainage, the levels of ALT, TB, DB, ALP,γ-GT and albumin of the patients underwent PTBD and PTBS all decreased in comparison with the baseline level(P<0.05). The levels of the PTBS group were significantly lower than those of the PTBD group, but the difference was not statistically significant among these 3 groups. The levels of ALT, TB, and DB of 37 patients underwent TACE all decreased in comparison with those before the treatment(P<0.05). The mean survival time of the external drainage group and external-internal drainage group was 3.3 and 5.0 months respectively, the PTBS group was 7.3 months. Conclusions:PTBD/PTBS is a technically feasible, and safe and clinically efficacious treatment for malignant biliary obstruction. It can relieve the clinical symptom and alleviate jaundice effectually; Therefore, the patients should receive PTBD in the early time in order to improve the life quality maximumly. Furthermore, TACE therapy following PTBD and PTBS will be significantly beneficial to decrease TB of MOJ patients.