Study Of Palliative Operation For Malignant Obstructive Jaundiced Patients

[Objective] To compare the three kinds of palliative surgical treatment the curativeeffect of patients with malignant obstructive jaundice.[Methods] Collected from January2010to December2012, our hospital114cases, divided into three groups, using different operation methods:Biliary stent insertion through operation, Biliary stent insertion through operation+I125particles implantation+neurolytic celiac plexus block, Roux-en-Y choledochojejunostomy+I125particles implantation, comparative analysis respectively for three kinds of palliative surgical operation time, intraoperative blood loss, bilirubin index, liver function recovery (AST ALT, ALP r-GT), surgical mortality and complication rate, postoperative hospitalization days, long-term quality of life and patient lifetime.[Results]There were85people followed-up.The follow-up rate was74.56%. Biliary stent insertion throung operatation+I125particles implantation+neurolytic celiac plexus block for the average operation time (159.7±11.7minutes), the average intraoperative blood loss (272.9±75.9ml), and the average hospitalization days postoperatively (17.12±3.30days)were all lower significantly than Roux-en-Y choledochojejunostomy+I125particles implantation at the average operation time (260.6±18.5minutes), the average intraoperative blood loss (647.3±123.4ml), average hospitalization days postoperatively (23.39±3.99days). The data of Biliary stent insertion throung operatation and Roux-en-Y choledochojejunostomy+I125particles implantation were statistical analysised, arrive at p<0.05, the difference is statistically significant; However Biliary stent insertion throung operatation+I125particles implantation+neurolytic celiac plexus block and Roux-en-Y choledochojejunostomy+I125particles implantation data statistical analysis, p＜0.05, the difference is statistically significant;Analysis of three surgical methods, yellow back in the near future effect and liver function recovery and complication rate after statistics test, P＞0.05, there was no statistically significant difference; In the long-term quality of life (the incidence of cholangitis, pain relief rate), survival period, the data statistical analysis, P＜0.05, the difference is statistically significant, Each index of the group of Biliary stent insertion through operation+I125particles implantation+neurolytic celiac plexus block and Biliary stent insertion throung operatation is superior to other two groups.Analysised statistical with the postoperative survival rate, incidence of biliary obstruction again, Compared with Roux-en-Y choledochojejunostomy+I125particles implantation, P＞0.05, there was no statistically significant difference.Compared with Biliary stent insertion throung operatation, P＜0.05, and the difference is statistically significant.The postoperative survival rate of Biliary stent insertion throung operatation+I125particles implantation+neurolytic celiac plexus block was higher and renewed the probability of bile duct obstruction was lower.[Conclusions]1. The three groups of Biliary stent insertion throung operatation, Biliary stent insertion throung operatation+I125particles implantation+neurolytic celiac plexus block, Roux-en-Y choledochojejunostomy+I125particles implantation were all can effectively relieve patients with biliary obstruction.Comepared with the bilirubin detection index, liver function index in preoperative and postoperative one week and one month postoperatively, P＞0.05, differences were not statistically significant.2.The Biliary stent insertion throung operatation+I125particles implantation+neurolytic celiac plexus block have the advantage of easier operation, less bleeding, fewer complications, higher survival rate, lower again probability of biliary obstruction and higher quality of forward life.